Sec. 3. Improving Federal efforts with respect to prevention of maternal mortality
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Not later than one year after the date of enactment of this Act, the Director of the Centers for Disease Control and Prevention (referred to in this section as the Director ) shall provide technical assistance to States that elect to report on maternal mortality for the purpose of encouraging uniformity in the reporting of such data and to encourage the sharing of such data among the respective States. Not later than one year after the date of enactment of this Act, the Director shall issue best practices to State maternal mortality review committees on how best to identify, review, and prevent maternal mortality.
In issuing such best practices, the Director shall take into account any data made available by States relating to maternal mortality. Not later than one year after the date of enactment of this Act, the Secretary of Health and Human Services, acting through the Associate Administrator of the Maternal and Child Health Bureau of the Health Resources and Services Administration, shall establish a grant program to be known as the Alliance for Innovation on Maternal Health Grant Program (referred to in this subsection as AIM ) under which the Secretary shall award grants to eligible entities for the purpose of directing widespread adoption and implementation of maternal safety bundles through collaborative State-based teams and collecting and analyzing process, structure, and outcome data to drive continuous improvement in the implementation of such safety bundles by such State-based teams with the ultimate goal of eliminating preventable maternal mortality and severe maternal morbidity in the United States.
In order to be eligible for a grant under paragraph (1), an entity shall— submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require; and demonstrate in such application that the entity is an interdisciplinary, multi-stakeholder national organization with a national data-driven maternal safety and quality improvement initiative based on implementation approaches that have been proven to improve maternal safety and outcomes in the United States.
An eligible entity that receives a grant under paragraph
(1)shall use such grant funds— to develop and implement, through a robust, multi-stakeholder process, maternal safety bundles to assist States and health care systems in aligning national, State, and hospital-level quality improvement efforts to improve maternal health outcomes, specifically the reduction of maternal mortality and severe maternal morbidity; to ensure, in developing and implementing maternal safety bundles under subparagraph (A), that such maternal safety bundles— satisfy the quality improvement needs of a State or health care system by factoring in the results and findings of relevant data reviews, such as reviews conducted by a State maternal mortality review committee; and address topics such as— obstetric hemorrhage; maternal mental health; the maternal venous system; obstetric care for women with opioid use disorder; postpartum care basics for maternal safety; reduction of peripartum racial and ethnic disparities; reduction of primary caesarean birth; severe hypertension in pregnancy; severe maternal morbidity reviews; support after a several maternal morbidity event; and thromboembolism; and to provide ongoing technical assistance at the national and State levels to support implementation of maternal safety bundles under subparagraph (A). For purposes of this subsection, the term maternal safety bundle means standardized, evidence-informed processes to improve variation in response to maternal care. For purposes of carrying out this subsection, there is authorized to be appropriated $5,000,000 for each of fiscal years 2019 through 2023. Section 1902 of the Social Security Act ( 42 U.S.C. 1396a ) is amended— in subsection (e)— in paragraph (5), by striking 60-day and inserting one-year ; and in paragraph (6), by striking 60-day and inserting one-year ; and in subsection (l)(1)(A), by striking 60-day and inserting one-year . Section 1903(v)(4)(A) of the Social Security Act ( 42 U.S.C. 1396b(v)(4)(A) ) is amended by striking 60-day and inserting one-year . Section 2112(d)(2)(A) of the Social Security Act ( 42 U.S.C. 1397ll(d)(2)(A) ) is amended by striking 60-day and inserting one-year . Section 1902(l) of the Social Security Act ( 42 U.S.C. 1396a(l) ) is amended by adding at the end the following new paragraph: Subject to subparagraph (B), during the period that begins on the date of enactment of this paragraph and ends on the date that is five years after such date of enactment, as a condition for receiving any Federal payments under section 1903(a) for calendar quarters occurring during such period, a State, including a State described in paragraph (4)(B) that elects to meet the requirement of subsection (a)(10)(A)(i)(IV), shall not have in effect, with respect to women who are eligible for medical assistance because of such subsection (a)(10)(A)(i)(IV) or section 1903(v)(4)(A)(i), eligibility standards, methodologies, or procedures under the State plan (or a waiver of such plan) that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) that are in effect on the date of enactment of this paragraph. A State’s determination of income in accordance with subsection (e)(14) shall not be considered to be eligibility standards, methodologies, or procedures that are more restrictive than the standards, methodologies, or procedures in effect under the State plan (or a waiver of such plan) on the date of enactment of this paragraph for purposes of determining compliance with the requirement of subparagraph (A). . Section 2105(d) of the Social Security Act ( 42 U.S.C. 1397ee(d) ) is amended by adding at the end the following new paragraph: During the period that begins on the date of enactment of this paragraph and ends on the date that is five years after such date of enactment, as a condition of receiving payments under subsection
(a)and section 1903(a), a State that elects to provide pregnancy-related assistance to targeted low-income pregnant women (as defined in section 2112(d)), or women who are eligible for such assistance through the application of section 1903(v)(4)(A)(i) under section 2107(e)(1), shall not have in effect, with respect to such women, eligibility standards, methodologies, or procedures under the State child health plan (or a waiver of such plan) that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) that are in effect on the date of enactment of this paragraph. . Except as otherwise provided and subject to subparagraph (B), the amendments made by this subsection shall take effect with respect to eligibility determinations made with respect to a State plan under title XIX of the Social Security Act or a State child health plan under title XXI of such Act on or after the date that is one year after the date of enactment of this Act. In the case of a State plan under title XIX of the Social Security Act or a State child health plan under title XXI of such Act that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this subsection, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature. Part P of title III of the Public Health Service Act is amended by adding at the end the following new section: Not later than one year after the date of enactment of this section, the Secretary, in consultation with such other agency heads as the Secretary determines appropriate, shall, subject to the availability of appropriations, award cooperative agreements for the establishment or support of regional centers of excellence addressing implicit bias and cultural competency in patient-provider interactions education for the purpose of enhancing and improving how health care professionals are educated in implicit bias and delivering culturally competent health care. To be eligible to receive a cooperative agreement under subsection (a), an entity shall— be an entity specified by the Secretary that provides educational opportunities for students in a health care profession, which may include a health system, teaching hospital, birthing center, community health center, physician’s office, medical school, school of public health, or any other health professional school or a program at an institution of higher education focused on the prevention, treatment, or recovery of health conditions that contribute to maternal mortality and the prevention of maternal mortality; demonstrate community engagement and participation through community partners such as mental health counselors and social workers; and provide to the Secretary such information, at such time and in such manner, as the Secretary may require. In awarding a cooperative agreement under subsection (a), the Secretary shall take into account any regional differences among eligible entities and make an effort to ensure geographic diversity among award recipients. The Secretary shall make publicly available on the Internet website of the Department of Health and Human Services information submitted to the Secretary under subsection (b)(3). The Secretary shall evaluate each regional center of excellence established or supported pursuant to subsection
(a)and disseminate the findings resulting from each such evaluation to the appropriate public and private entities. In this section, the term maternal mortality means death that occurs to a woman during pregnancy or within the one-year period following the end of such pregnancy. For purposes of carrying out this section, there is authorized to be appropriated $5,000,000 for each of fiscal years 2019 through 2023. . In this section: The term maternal mortality means death that occurs to a woman during pregnancy or within the one-year period following the end of such pregnancy. The term severe maternal morbidity includes unexpected outcomes of labor and delivery that result in significant short-term or long-term consequences to a woman’s health.
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Sec. 3
Improving Federal efforts with respect to prevention of maternal mortality
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