Sec. 104. Rural maternal and obstetric care training demonstration
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Subpart 1 of part E of title VII of the Public Health Service Act is amended by inserting after section 760 ( 42 U.S.C. 294n et seq.), as amended by section 202, is amended by adding at the end the following: The Secretary shall establish a training demonstration program to award grants to eligible entities to support— training for physicians, medical residents, including family medicine and obstetrics and gynecology residents, and fellows to practice maternal and obstetric medicine in rural community-based settings; training for nurse practitioners, physician assistants, nurses, certified nurse midwives, home visiting nurses and non-clinical home visiting workforce professionals and paraprofessionals, or non-clinical professionals, who meet applicable State training and licensing requirements, to provide maternal care services in rural community-based settings; and establishing, maintaining, or improving academic units or programs that— provide training for students or faculty, including through clinical experiences and research, to improve maternal care in rural areas; or develop evidence-based practices or recommendations for the design of the units or programs described in subparagraph (A), including curriculum content standards.
A recipient of a grant under subsection (a)(1)— shall use the grant funds— to plan, develop, and operate a training program to provide obstetric care in rural areas for family practice or obstetrics and gynecology residents and fellows; or to train new family practice or obstetrics and gynecology residents and fellows in maternal and obstetric health care to provide and expand access to maternal and obstetric health care in rural areas; and may use the grant funds to provide additional support for the administration of the program or to meet the costs of projects to establish, maintain, or improve faculty development, or departments, divisions, or other units necessary to implement such training.
A recipient of a grant under subsection (a)(2)— shall use the grant funds to plan, develop, or operate a training program to provide maternal health care services in rural, community-based settings; and may use the grant funds to provide additional support for the administration of the program or to meet the costs of projects to establish, maintain, or improve faculty development, or departments, divisions, or other units necessary to implement such program. The recipient of a grant under subsection (a)(1) or (a)(2) shall ensure that training programs carried out under the grant are evidence-based and include instruction on— maternal mental health, including perinatal depression and anxiety; maternal substance use disorder; social determinants of health that impact individuals living in rural communities, including poverty, social isolation, access to nutrition, education, transportation, and housing; and implicit bias.
To be eligible to receive a grant under subsection (a)(1), an entity shall— be a consortium consisting of— at least one teaching health center; or the sponsoring institution (or parent institution of the sponsoring institution) of— an obstetrics and gynecology or family medicine residency program that is accredited by the Accreditation Council of Graduate Medical Education (or the parent institution of such a program); or a fellowship in maternal or obstetric medicine, as determined appropriate by the Secretary; or be an entity described in subparagraph (A)(ii) that provides opportunities for medical residents or fellows to train in rural community-based settings.
To be eligible to receive a grant under subsection (a)(2), an entity shall be— a teaching health center (as defined in section 749A(f)); a federally qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act); a community mental health center (as defined in section 1861(ff)(3)(B) of the Social Security Act); a rural health clinic (as defined in section 1861(aa) of the Social Security Act); a freestanding birth center (as defined in section 1905(l)(3) of the Social Security Act); or an Indian Health Program or a Native Hawaiian health care system (as such terms are defined in section 4 of the Indian Health Care Improvement Act and section 12 of the Native Hawaiian Health Care Improvement Act, respectively).
To be eligible to receive a grant under subsection (a)(3), an entity shall be a school of medicine, a school of osteopathic medicine, a school of nursing (as defined in section 801), a physician assistant education program, an accredited public or nonprofit private hospital, an accredited medical residency training program, a school accredited by the Midwifery Education and Accreditation Council, by the Accreditation Commission for Midwifery Education, or by the American Midwifery Certification Board, or a public or private nonprofit educational entity which the Secretary has determined is capable of carrying out such grant.
To be eligible to receive a grant under subsection (a), an entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including an estimate of the amount to be expended to conduct training activities under the grant (including ancillary and administrative costs). The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall conduct a study on the results of the demonstration program under this section.
Not later than 90 days after the completion of the first year of the training program, and each subsequent year for the duration of the grant, that the program is in effect, each recipient of a grant under subsection
(a)shall submit to the Secretary such data as the Secretary may require for analysis for the report described in paragraph (2). Not later than 1 year after receipt of the data described in paragraph (1)(B), the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report that includes— an analysis of the effect of the demonstration program under this section on the quality, quantity, and distribution of maternal (including prenatal, labor and birth, and postpartum) care services and the demographics of the recipients of those services; an analysis of maternal and infant health outcomes (including quality of care, morbidity, and mortality) before and after implementation of the program in the communities served by entities participating in the demonstration; and recommendations on whether the demonstration program should be expanded. There is authorized to be appropriated to carry out this section, $5,000,000 for each of fiscal years 2020 through 2024. .
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Sec. 104
Rural maternal and obstetric care training demonstration
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