Sec. 5203. Social determinants for moms
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/bill/118/hr/9161/ih/section-5203·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
The Secretary of Health and Human Services shall convene a task force (in this subsection referred to as the Task Force ) to develop a strategy to coordinate efforts between Federal agencies to address social determinants of maternal health with respect to pregnant and postpartum individuals. The ex officio members of the Task Force shall consist of the following: The Secretary of Health and Human Services (or a designee thereof). The Secretary of Housing and Urban Development (or a designee thereof).
The Secretary of Transportation (or a designee thereof). The Secretary of Agriculture (or a designee thereof). The Secretary of Labor (or a designee thereof). The Administrator of the Environmental Protection Agency (or a designee thereof). The Assistant Secretary for the Administration for Children and Families (or a designee thereof). The Administrator of the Centers for Medicare & Medicaid Services (or a designee thereof). The Director of the Indian Health Service (or a designee thereof).
The Director of the National Institutes of Health (or a designee thereof). The Administrator of the Health Resources and Services Administration (or a designee thereof). The Deputy Assistant Secretary for Minority Health of the Department of Health and Human Services (or a designee thereof). The Deputy Assistant Secretary for Women’s Health of the Department of Health and Human Services (or a designee thereof). The Director of the Centers for Disease Control and Prevention (or a designee thereof).
The Director of the Office on Violence Against Women of the Department of Justice (or a designee thereof). In addition to the ex officio members of the Task Force, the Secretary of Health and Human Services shall appoint the following members of the Task Force: At least two representatives of patients, to include— a representative of patients who have suffered from severe maternal morbidity; or a representative of patients who is a family member of an individual who suffered a pregnancy-related death.
At least two leaders of community-based organizations that address maternal mortality and severe maternal morbidity with a specific focus on racial and ethnic inequities. In appointing such leaders under this subparagraph, the Secretary of Health and Human Services shall give priority to individuals who are leaders of organizations led by individuals from racial and ethnic minority groups. At least two perinatal health workers. A professionally diverse panel of maternity care providers.
The Secretary of Health and Human Services shall select the chair of the Task Force from among the members of the Task Force. Not later than 2 years after the date of enactment of this Act, the Task Force shall submit to Congress a report on— the strategy developed under paragraph (1); recommendations on funding amounts with respect to implementing such strategy; and recommendations for how to expand coverage of social services to address social determinants of maternal health under Medicaid managed care organizations and State Medicaid programs.
Section 1013 of title 5, United States Code, shall not apply to the Task Force with respect to termination. In this subsection: The term eligible entity means— a community-based organization; a State or local governmental entity, including a State or local public health department; an Indian tribe or Tribal organization (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5304 )); or an Urban Indian organization (as such term is defined in section 4 of the Indian Health Care Improvement Act ( 25 U.S.C. 1603 )).
The term Secretary means the Secretary of Housing and Urban Development. The Secretary shall establish a Housing for Moms grant program to make grants to eligible entities to increase access to safe, stable, affordable, and adequate housing for pregnant and postpartum individuals and their families. To be eligible to receive a grant under this subsection, an eligible entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may provide.
In awarding grants under this subsection, the Secretary shall give priority to an eligible entity that— is a community-based organization or will partner with a community-based organization to implement initiatives to increase access to safe, stable, affordable, and adequate housing for pregnant and postpartum individuals and their families; is operating in an area with high rates of adverse maternal health outcomes or significant racial or ethnic inequities in maternal health outcomes, to the extent such data are available; and is operating in an area with a high poverty rate or a significant number of individuals who lack consistent access to safe, stable, affordable, and adequate housing.
An eligible entity that receives a grant under this subsection shall use funds from the grant for the purposes of— identifying and conducting outreach to pregnant and postpartum individuals who are low-income and lack consistent access to safe, stable, affordable, and adequate housing; providing safe, stable, affordable, and adequate housing options to such individuals; connecting such individuals with local organizations offering safe, stable, affordable, and adequate housing options; providing application assistance to such individuals seeking to enroll in programs offering safe, stable, affordable, and adequate housing options; providing direct financial assistance to such individuals for the purposes of maintaining safe, stable, and adequate housing for the duration of the individual’s pregnancy and postpartum periods; and working with relevant stakeholders to ensure that local housing and homeless shelter infrastructure is supportive to pregnant and postpartum individuals, including through— health-promoting housing codes; enforcement of housing codes; proactive rental inspection programs; code enforcement officer training; and partnerships between regional offices of the Department of Housing and Urban Development and community-based organizations to ensure housing laws are understood and violations are discovered.
The Secretary shall require each eligible entity receiving a grant under this subsection to annually submit to the Secretary and make publicly available a report on the status of activities conducted using the grant. Not later than the end of each fiscal year in which grants are made under this subsection, the Secretary shall submit to Congress and make publicly available a report that— summarizes the reports received under subparagraph (A); evaluates the effectiveness of grants awarded under this subsection in increasing access to safe, stable, affordable, and adequate housing for pregnant and postpartum individuals and their families; and makes recommendations with respect to ensuring activities described in paragraph
(5)continue after grant amounts made available under this subsection are expended. There is authorized to be appropriated to carry out this subsection $10,000,000 for fiscal year 2025, which shall remain available until expended. Not later than 1 year after the date of enactment of this Act, the Secretary of Transportation shall submit to Congress and make publicly available a report containing— an assessment of transportation barriers preventing individuals from attending prenatal and postpartum appointments, accessing maternal health care services, or accessing services and resources related to social determinants of maternal health; recommendations on how to overcome the barriers assessed under subparagraph (A); and an assessment of transportation safety risks for pregnant individuals and recommendations on how to mitigate those risks. In carrying out paragraph (1), the Secretary of Transportation shall give special consideration to solutions for— pregnant and postpartum individuals living in a health professional shortage area designated under section 332 of the Public Health Service Act ( 42 U.S.C. 254e ); pregnant and postpartum individuals living in areas with high maternal mortality or severe morbidity rates or significant racial or ethnic inequities in maternal health outcomes; and pregnant and postpartum individuals with a disability that impacts mobility. Section 17(b)(10) of the Child Nutrition Act of 1966 ( 42 U.S.C. 1786(b)(10) ) is amended by striking six and inserting 24 . Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress a report that evaluates the effect of the amendment made by subparagraph
(A)on— maternal and infant health outcomes, including racial and ethnic inequities with respect to those outcomes; breastfeeding rates among postpartum individuals; qualitative evaluations of family experiences under the special supplemental nutrition program for women, infants, and children established under section 17 of the Child Nutrition Act of 1966 ( 42 U.S.C. 1786 ); and other relevant information as determined by the Secretary. The Secretary shall establish a program (referred to in this paragraph as the program ) to award grants, on a competitive basis, to eligible entities to carry out the activities described in subparagraph (D). To be eligible for a grant under the program, an eligible entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary determines appropriate. In awarding grants under the program, the Secretary shall give priority to an eligible entity that— is, or will partner with, an eligible entity described in paragraph (3)(A)(i); and is operating in an area with a high rate of— adverse maternal health outcomes; or significant racial or ethnic inequities in maternal health outcomes. An eligible entity shall use a grant awarded under the program to deliver healthy food, infant formula, clean water, or diapers to pregnant and postpartum individuals located in areas that are food deserts, as determined by the Secretary using data from the Food Access Research Atlas of the Department of Agriculture. Not later than 1 year after the date on which an eligible entity receives a grant under the program, and annually thereafter, the eligible entity shall submit to the Secretary a report on the status of activities conducted using the grant, which shall contain such information as the Secretary may require. Not later than 2 years after the date on which the first grant is awarded under the program, the Secretary shall submit to Congress a report that includes— a summary of the reports submitted by eligible entities under clause (i); an assessment of the extent to which food distributed using grants awarded under the program was purchased from local and regional food systems; an evaluation of the effect of the program on maternal and infant health outcomes, including racial and ethnic inequities with respect to those outcomes; and recommendations with respect to ensuring the activities described in subparagraph
(D)continue after the grant period funding those activities expires. The Secretary shall make the report submitted under subclause
(I)publicly available on the website of the Department of Agriculture. There is authorized to be appropriated to carry out the program $5,000,000 for the period of fiscal years 2025 through 2027. In this subsection: The term eligible entity means— a community-based organization; a State or local governmental entity, including a State or local public health department; an Indian Tribe or Tribal organization (as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5304 )); and an Urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act ( 25 U.S.C. 1603 )). The term Secretary means the Secretary of Agriculture. Not later than 60 days after the date of enactment of this Act, the Administrator of the Environmental Protection Agency shall seek to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine (referred to in this subsection as the National Academies ) under which the National Academies agree to conduct a study on the impacts of, with respect to maternal and infant health incomes, water and air quality, exposure to extreme temperatures, environmental chemicals, environmental risks in the workplace and the home, and pollution levels. The agreement under paragraph
(1)shall direct the National Academies to make recommendations for— improving environmental conditions to improve maternal and infant health outcomes; and reducing or eliminating racial and ethnic inequities in those outcomes. The agreement under paragraph
(1)shall direct the National Academies to complete the study under this subsection, and submit to Congress and make publicly available a report on the results of the study, not later than 1 year after the date of enactment of this Act. The Secretary of Health and Human Services (in this subsection referred to as the Secretary ) shall award grants to eligible organizations to carry out programs to provide pregnant and postpartum individuals with free and accessible drop-in child care services during prenatal and postpartum appointments. To be eligible to receive a grant under this subsection, an eligible entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. To be eligible to receive a grant under this subsection, an organization shall be an organization that— provides child care services; and can carry out a program providing pregnant and postpartum individuals with free and accessible drop-in child care services during prenatal and postpartum appointments. In selecting grant recipients under this subsection, the Secretary shall give priority to eligible organizations that operate in an area that has, to the extent data with respect to such an area are available— high rates of adverse maternal health outcomes; or significant racial or ethnic inequities in maternal health outcomes. The Secretary shall commence the grant program under paragraph
(1)not later than 1 year after the date of enactment of this Act. Each recipient of a grant under this subsection shall annually submit to the Secretary and make publicly available a report on the status of activities conducted using the grant. Each such report shall include— an analysis of the effect of the funded program on prenatal and postpartum appointment attendance rates; summaries of qualitative assessments of the funded program from— pregnant and postpartum individuals participating in the program; and the families of such individuals; and such additional information as the Secretary may require. Not later than the end of fiscal year 2027, the Secretary shall submit to the Congress, and make publicly available, a report containing each of the following: A summary of the reports received under subparagraph (A). An assessment of the effects, if any, of the funded programs on maternal health outcomes, with a specific focus on racial and ethnic inequities in such outcomes. A description of actions the Secretary can take to ensure that pregnant and postpartum individuals eligible for medical assistance under a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1936 et seq. ) have access to free and accessible drop-in child care services during prenatal and postpartum appointments, including identification of the funding necessary to carry out such actions. In this subsection, the term drop-in child care services means child care (including early childhood education) services that are— delivered at a facility that meets the requirements of all applicable laws and regulations of the State or local government in which it is located, including the requirements for licensing of the facility as a child care facility; and provided in single encounters without requiring full-time enrollment of a person in a child care program. To carry out this subsection, there is authorized to be appropriated $5,000,000 for the period of fiscal years 2025 through 2027. The Secretary of Health and Human Services (in this subsection referred to as the Secretary ) shall award grants to eligible entities to— address social determinants of maternal health for pregnant and postpartum individuals; and eliminate racial and ethnic inequities in maternal health outcomes. To be eligible to receive a grant under this subsection an eligible entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may provide. In awarding grants under paragraph (1), the Secretary shall give priority to an eligible entity that— is a community-based organization, or will partner with a community-based organization to carry out the activities under paragraph (4); is operating in an area with high rates of adverse maternal health outcomes or significant racial or ethnic inequities in maternal health outcomes; and is operating in an area with a high poverty rate. An eligible entity that receives a grant under this subsection may use funds received through the grant to— hire and retain staff; develop and distribute a list of available resources with respect to social service programs in a community; establish a resource center that provides multiple social service programs in a single location; offer programs and resources in the communities in which the respective eligible entities are located to address social determinants of health for pregnant and postpartum individuals; and consult with such pregnant and postpartum individuals to conduct an assessment of the activities under this paragraph. The Secretary shall provide to grant recipients under this subsection technical assistance to plan for sustaining programs to address social determinants of maternal health among pregnant and postpartum individuals after the period of the grant. Not later than 1 year after the date on which an eligible entity first receives a grant under this subsection, and annually thereafter, an eligible entity shall submit to the Secretary, and make publicly available, a report on the status of activities conducted using the grant. Each such report shall include data on the effects of such activities, disaggregated by race, ethnicity, gender, and other relevant factors. Not later than the end of fiscal year 2029, the Secretary shall submit to Congress a report that includes— a summary of the reports received under subparagraph (A); and recommendations for— improving maternal health outcomes; and reducing or eliminating racial and ethnic inequities in maternal health outcomes. There is authorized to be appropriated to carry out this subsection $15,000,000 for each of fiscal years 2025 through 2029. In this section: The term culturally congruent , with respect to care or maternity care provided to a health care consumer, means care that is in agreement with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other relevant stakeholders. The term maternity care provider means a health care provider who— is a physician, physician assistant, midwife who meets at a minimum the international definition of the midwife and global standards for midwifery education as established by the International Confederation of Midwives, nurse practitioner, or clinical nurse specialist; and has a focus on maternal or perinatal health. The term maternal mortality means a death occurring during or within a one-year period after pregnancy, caused by pregnancy-related or childbirth complications, including a suicide, overdose, or other death resulting from a mental health or substance use disorder attributed to or aggravated by pregnancy-related or childbirth complications. The term perinatal health worker means a doula, community health worker, peer supporter, breastfeeding and lactation educator or counselor, nutritionist or dietitian, childbirth educator, social worker, home visitor, language interpreter, or navigator. The terms postpartum and postpartum period refer to the 1-year period beginning on the last day of the pregnancy of an individual. The term racial and ethnic minority group has the meaning given such term in section 1707(g)(1) of the Public Health Service Act ( 42 U.S.C. 300u–6(g)(1) ). The term severe maternal morbidity means a health condition, including mental health conditions and substance use disorders, attributed to or aggravated by pregnancy or childbirth that results in significant short-term or long-term consequences to the health of the individual who was pregnant. The term social determinants of maternal health means non-clinical factors that impact maternal health outcomes, including— economic factors, which may include poverty, employment, food security, support for and access to lactation and other infant feeding options, housing stability, and related factors; neighborhood factors, which may include quality of housing, access to transportation, access to child care, availability of healthy foods and nutrition counseling, availability of clean water, air and water quality, ambient temperatures, neighborhood crime and violence, access to broadband, and related factors; social and community factors, which may include systemic racism, gender discrimination or discrimination based on other protected classes, workplace conditions, incarceration, and related factors; household factors, which may include ability to conduct lead testing and abatement, car seat installation, indoor air temperatures, and related factors; education access and quality factors, which may include educational attainment, language and literacy, and related factors; and health care access factors, including health insurance coverage, access to culturally congruent health care services, providers, and non-clinical support, access to home visiting services, access to wellness and stress management programs, health literacy, access to telehealth and items required to receive telehealth services, and related factors.
Connectionstraces to 4
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- 42 USC 1936
- 42 USC 300u–6(g)(1)
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Sec. 5203
Social determinants for moms
Cite42 USC 1936
Cite42 USC 300u–6(g)(1)
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