Momnibus Act

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 7973 Introduced in House (IH)]

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119th CONGRESS 2d Session H. R. 7973

To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes.

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IN THE HOUSE OF REPRESENTATIVES

March 18, 2026

Ms. Underwood (for herself, Ms. Adams, Mr. Aguilar, Mr. Amo, Ms. Ansari, Ms. Balint, Ms. Barragan, Mrs. Beatty, Mr. Bell, Mr. Bera, Mr. Bishop, Ms. Bonamici, Mr. Boyle of Pennsylvania, Ms. Brown, Ms. Brownley, Mr. Carbajal, Mr. Carson, Mr. Carter of Louisiana, Mr. Casten, Ms. Castor of Florida, Mr. Castro of Texas, Mrs. Cherfilus- McCormick, Ms. Chu, Ms. Clark of Massachusetts, Ms. Clarke of New York, Mr. Cleaver, Mr. Clyburn, Mr. Cohen, Mr. Conaway, Mr. Correa, Mr. Courtney, Ms. Craig, Ms. Crockett, Mr. Crow, Mr. Cuellar, Ms. Davids of Kansas, Mr. Davis of Illinois, Ms. Dean of Pennsylvania, Ms. DeGette, Mrs. McClain Delaney, Ms. DeLauro, Ms. DelBene, Mr. Deluzio, Mr. DeSaulnier, Ms. Dexter, Mrs. Dingell, Ms. Elfreth, Ms. Escobar, Mr. Espaillat, Mr. Fields, Mr. Figures, Mrs. Fletcher, Mr. Foster, Mrs. Foushee, Ms. Lois Frankel of Florida, Mr. Frost, Mr. Garamendi, Ms. Garcia of Texas, Mr. Garcia of Illinois, Mr. Garcia of California, Mr. Golden of Maine, Mr. Goldman of New York, Mr. Vicente Gonzalez of Texas, Ms. Goodlander, Mr. Gottheimer, Mr. Gray, Mr. Green of Texas, Mrs. Grijalva, Mr. Harder of California, Mrs. Hayes, Mr. Horsford, Ms. Houlahan, Mr. Hoyer, Ms. Hoyle of Oregon, Mr. Huffman, Mr. Ivey, Mr. Jackson of Illinois, Ms. Jacobs, Ms. Jayapal, Mr. Jeffries, Mr. Johnson of Georgia, Ms. Johnson of Texas, Ms. Kamlager-Dove, Ms. Kaptur, Ms. Kelly of Illinois, Mr. Kennedy of New York, Mr. Khanna, Mr. Krishnamoorthi, Mr. Landsman, Mr. Larsen of Washington, Mr. Larson of Connecticut, Mr. Latimer, Ms. Lee of Pennsylvania, Ms. Lee of Nevada, Ms. Leger Fernandez, Mr. Levin, Mr. Liccardo, Mr. Lieu, Mr. Lynch, Mr. Magaziner, Mr. Mannion, Ms. Matsui, Mrs. McBath, Ms. McBride, Ms. McClellan, Ms. McCollum, Ms. McDonald Rivet, Mr. McGarvey, Mr. McGovern, Mrs. McIver, Mr. Meeks, Mr. Menefee, Mr. Menendez, Mr. Mfume, Mr. Min, Ms. Moore of Wisconsin, Mr. Morelle, Mr. Moskowitz, Mr. Moulton, Mr. Mrvan, Mr. Mullin, Mr. Nadler, Mr. Neguse, Mr. Norcross, Ms. Norton, Ms. Ocasio-Cortez, Mr. Olszewski, Ms. Omar, Mr. Panetta, Mr. Pappas, Ms. Pelosi, Ms. Pettersen, Ms. Pingree, Ms. Plaskett, Mr. Pocan, Ms. Pressley, Mr. Quigley, Mrs. Ramirez, Ms. Randall, Mr. Raskin, Mr. Riley of New York, Ms. Rivas, Ms. Ross, Mr. Ruiz, Mr. Ryan, Ms. Salinas, Ms. Scanlon, Ms. Schakowsky, Mr. Schneider, Ms. Scholten, Ms. Schrier, Mr. David Scott of Georgia, Mr. Scott of Virginia, Ms. Sewell, Mr. Sherman, Ms. Simon, Mr. Smith of Washington, Mr. Sorensen, Mr. Soto, Ms. Stansbury, Mr. Stanton, Ms. Stevens, Ms. Strickland, Mr. Subramanyam, Mr. Suozzi, Mr. Swalwell, Mr. Takano, Mr. Thanedar, Mr. Thompson of California, Mr. Thompson of Mississippi, Ms. Titus, Ms. Tlaib, Ms. Tokuda, Mr. Tonko, Mr. Torres of New York, Mrs. Trahan, Mr. Tran, Mr. Vargas, Mr. Veasey, Mr. Vindman, Mr. Walkinshaw, Ms. Wasserman Schultz, Ms. Waters, Mrs. Watson Coleman, Ms. Williams of Georgia, Ms. Wilson of Florida, Mr. Evans of Pennsylvania, Mr. Gomez, Mr. Casar, Mr. Himes, Ms. Pou, Mrs. Torres of California, Ms. Budzinski, Ms. Bynum, Ms. Friedman, Mr. Keating, Mrs. Sykes, Mr. Neal, Mr. Hernandez, and Mr. Costa) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, Veterans' Affairs, Natural Resources, and the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

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A BILL

To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Momnibus Act''.

SEC. 2. TABLE OF CONTENTS.

The table of contents for this Act is as follows:

Sec. 1. Short title. Sec. 2. Table of contents. Sec. 3. Definitions. Sec. 4. Sense of Congress. TITLE I--SOCIAL DETERMINANTS FOR MOMS

Sec. 101. Task force to address the United States maternal health crisis. Sec. 102. Sustained funding to address social determinants of maternal health. TITLE II--EXTENDING WIC FOR NEW MOMS

Sec. 201. Extending WIC eligibility for new moms. TITLE III--HONORING KIRA JOHNSON

Sec. 301. Sustained funding for community-based organizations to advance maternal health equity. Sec. 302. Respectful maternity care training for all employees in maternity care settings. Sec. 303. Study on reducing and preventing bias, racism, and discrimination in maternity care settings. Sec. 304. Respectful maternity care compliance program. Sec. 305. GAO report. TITLE IV--MATERNAL HEALTH FOR VETERANS

Sec. 401. Support for maternity health care and coordination programs of the Department of Veterans Affairs. TITLE V--PERINATAL WORKFORCE

Sec. 501. HHS agency directives. Sec. 502. Grants to grow and diversify the perinatal workforce. Sec. 503. Grants to grow and diversify the nursing workforce in maternal and perinatal health. Sec. 504. GAO report. TITLE VI--DATA TO SAVE MOMS

Sec. 601. Funding for maternal mortality review committees to promote representative community engagement. Sec. 602. Data collection and review. Sec. 603. Review of maternal health data collection processes and quality measures. Sec. 604. Study on maternal health among American Indian and Alaska Native individuals. Sec. 605. Grants to minority-serving institutions to study maternal mortality, severe maternal morbidity, and other adverse maternal health outcomes. TITLE VII--MOMS MATTER

Sec. 701. Maternal mental health equity grant program. Sec. 702. Grants to grow and diversify the maternal mental and behavioral health care workforce. TITLE VIII--JUSTICE FOR INCARCERATED MOMS

Sec. 801. Ending the shackling of pregnant individuals. Sec. 802. Creating model programs for the care of incarcerated individuals in the prenatal and postpartum periods. Sec. 803. Grant program to improve maternal health outcomes for individuals in State and local prisons and jails. Sec. 804. GAO report. TITLE IX--TECH TO SAVE MOMS

Sec. 901. Integrated telehealth models in maternity care services. Sec. 902. Grants to expand the use of technology-enabled collaborative learning and capacity models for pregnant and postpartum individuals. Sec. 903. Grants to promote equity in maternal health outcomes through digital tools. Sec. 904. Report on the use of technology in maternity care. TITLE X--IMPACT TO SAVE MOMS

Sec. 1001. Perinatal Care Alternative Payment Model Demonstration Project. TITLE XI--MATERNAL HEALTH PANDEMIC RESPONSE

Sec. 1101. Definitions. Sec. 1102. Funding for data collection, surveillance, and research on maternal health outcomes during public health emergencies. Sec. 1103. Public health emergency maternal health data collection and disclosure. Sec. 1104. Public health communication regarding maternal care during public health emergencies. Sec. 1105. Task force on birthing experience and safe, respectful, responsive, and empowering maternity care during public health emergencies. TITLE XII--PROTECTING MOMS AND BABIES AGAINST CLIMATE CHANGE

Sec. 1201. Definitions. Sec. 1202. Grant program to protect vulnerable mothers and babies from climate change risks. Sec. 1203. Grant program for education and training at health profession schools. Sec. 1204. NIH Consortium on Birth and Climate Change Research. Sec. 1205. Strategy for identifying climate change risk zones for vulnerable mothers and babies. TITLE XIII--NIH IMPROVE

Sec. 1301. IMPROVE Initiative. TITLE XIV--MATERNAL VACCINATIONS

Sec. 1401. Maternal vaccination awareness and equity campaign.

SEC. 3. DEFINITIONS.

In this Act: (1) Culturally and linguistically congruent.--The term ``culturally and linguistically congruent'', with respect to care or maternity care, means care that is in agreement with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other stakeholders. (2) Maternal mortality.--The term ``maternal mortality'' means a death occurring during or within a 1-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. (3) Maternity care provider.--The term ``maternity care provider'' means a health care provider who-- (A) is a physician, a physician assistant, a midwife who meets, at a minimum, the international definition of a midwife and global standards for midwifery education as established by the International Confederation of Midwives, an advanced practice registered nurse, a doula accredited by a State to receive reimbursement for doula services under a State plan (or a waiver of such plan) under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), or a lactation consultant certified by the International Board of Lactation Consultant Examiners; and (B) has a focus on maternal or perinatal health. (4) Perinatal health worker.--The term ``perinatal health worker'' means a nonclinical health worker focused on maternal or perinatal health, such as a doula, community health worker, peer supporter, lactation educator or counselor, nutritionist or dietitian, childbirth educator, social worker, home visitor, patient navigator or coordinator, or language interpreter. (5) Postpartum and postpartum period.--The terms ``postpartum'' and ``postpartum period'' refer to the 1-year period beginning on the last day of the pregnancy of an individual. (6) Pregnancy-associated death.--The term ``pregnancy- associated death'' means a death of a pregnant or postpartum individual, by any cause, that occurs during, or within 1 year following, the individual's pregnancy, regardless of the outcome, duration, or site of the pregnancy. (7) Pregnancy-related death.--The term ``pregnancy-related death'' means a death of a pregnant or postpartum individual that occurs during, or within 1 year following, the individual's pregnancy, from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy. (8) Public health emergency.--The term ``public health emergency'' means a public health emergency declared under section 319 of the Public Health Service Act (42 U.S.C. 247d). (9) Racial and ethnic minority group.--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)). (10) Severe maternal morbidity.--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. (11) Social determinants of maternal health.--The term ``social determinants of maternal health'' means nonclinical factors that impact maternal health outcomes.

SEC. 4. SENSE OF CONGRESS.

It is the sense of Congress that-- (1) the respect and proper care that birthing people deserve is inclusive; and (2) regardless of race, ethnicity, gender identity, sexual orientation, religion, marital status, primary language, familial status, socioeconomic status, immigration status, incarceration status, or disability, all deserve dignity.

TITLE I--SOCIAL DETERMINANTS FOR MOMS

SEC. 101. TASK FORCE TO ADDRESS THE UNITED STATES MATERNAL HEALTH CRISIS.

(a) In General.--The Secretary of Health and Human Services shall convene a task force (in this section referred to as the ``Task Force'') to develop strategies and coordinate efforts between Federal agencies and other stakeholders to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, including actions to address clinical and nonclinical causes of maternal mortality, severe maternal morbidity, and maternal health disparities. (b) Ex Officio Members.--The ex officio members of the Task Force shall consist of the following: (1) The Secretary of Health and Human Services (or a designee thereof). (2) The Secretary of Housing and Urban Development (or a designee thereof). (3) The Secretary of Transportation (or a designee thereof). (4) The Secretary of Agriculture (or a designee thereof). (5) The Secretary of Labor (or a designee thereof). (6) The Administrator of the Environmental Protection Agency (or a designee thereof). (7) The Assistant Secretary for the Administration for Children and Families (or a designee thereof). (8) The Administrator of the Centers for Medicare & Medicaid Services (or a designee thereof). (9) The Director of the Indian Health Service (or a designee thereof). (10) The Director of the National Institutes of Health (or a designee thereof). (11) The Director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (or a designee thereof). (12) The Director of the Tribal Health Research Office of the National Institutes of Health (or a designee thereof). (13) The Administrator of the Health Resources and Services Administration (or a designee thereof). (14) The Deputy Assistant Secretary for Minority Health of the Department of Health and Human Services (or a designee thereof). (15) The Deputy Assistant Secretary for Women's Health of the Department of Health and Human Services (or a designee thereof). (16) The Director of the Centers for Disease Control and Prevention (or a designee thereof). (17) The Director of the Office on Violence Against Women at the Department of Justice (or a designee thereof). (c) Appointed Members.--In addition to the ex officio members of the Task Force, the Secretary of Health and Human Services may appoint the following members of the Task Force: (1) Representatives of patients, to include-- (A) a representative of patients who have suffered from severe maternal morbidity; or (B) a representative of patients who is a family member of an individual who suffered a pregnancy- related death. (2) Leaders of community-based organizations that address maternal mortality, severe maternal morbidity, and maternal health with a specific focus on racial and ethnic disparities. In appointing such leaders under this paragraph, the Secretary of Health and Human Services shall give priority to individuals who are leaders of organizations led by individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes. (3) Leaders from the Indian health care system, including leaders from Tribal Epidemiology Centers. (4) Perinatal health workers. (5) A professionally and geographically diverse panel of maternity care providers. (6) Other maternal health stakeholders outside of the Federal Government with expertise in maternal health, including social determinants of maternal health. (d) Chair.--The Secretary of Health and Human Services shall select the chair of the Task Force from among the members of the Task Force. (e) Topics.--In developing strategies coordinating efforts between Federal agencies and other stakeholders to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States under this section, the Task Force may address topics such as-- (1) addressing barriers that prevent individuals from attending prenatal and postpartum appointments, accessing maternal health care services, or accessing services and resources related to social determinants of maternal health; (2) increasing access to safe, stable, affordable, and adequate housing for pregnant and postpartum individuals and their families; (3) delivering healthy food, infant formula, clean water, diapers, or other perinatal necessities to pregnant and postpartum individuals located in areas that are food deserts; (4) addressing the impacts of water and air quality, exposure to extreme temperatures, environmental chemicals, environmental risks in the workplace and the home, and pollution levels, on maternal and infant health outcomes; (5) offering free and accessible drop-in childcare services during prenatal and postpartum appointments; (6) addressing the clinical and nonclinical needs of postpartum individuals and their families for the duration of the postpartum period; (7) engaging with nongovernmental entities to address social determinants of maternal health, including through public-private partnerships; (8) addressing the impact of domestic or intimate partner violence on maternal health outcomes; and (9) other topics determined by the chair of the Task Force. (f) Report.--Not later than 2 years after the date of enactment of this Act, and every year thereafter, the Task Force shall submit to Congress and make publicly available on the website of the Department of Health and Human Services a report-- (1) describing the Task Force's efforts to develop strategies and coordinate efforts between Federal agencies and other stakeholders to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States; (2) providing an overview of actions taken by each member of the Task Force listed under subsection (b) to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States; (3) providing recommendations on Federal funding amounts and authorities needed to implement strategies developed by the Task Force to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States; (4) providing recommendations on actions that stakeholders outside of the Federal Government can take to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States; and (5) addressing other topics as determined by the chair of the Task Force. (g) Termination.--Section 1013 of title 5, United States Code, shall not apply to the Task Force with respect to termination.

SEC. 102. SUSTAINED FUNDING TO ADDRESS SOCIAL DETERMINANTS OF MATERNAL HEALTH.

(a) In General.--The Secretary of Health and Human Services (in this section referred to as the ``Secretary'') shall award grants to eligible entities to address social determinants of maternal health to eliminate maternal mortality, severe maternal morbidity, and maternal health disparities. (b) Eligible Entities.--In this section, the term ``eligible entity'' means-- (1) a community-based organization, Indian Tribe or Tribal organization, or Urban Indian organization; (2) a public health department or nonprofit organization working with an entity listed in paragraph (1); or (3) a consortium of entities listed in paragraph (1) or (2) that includes at minimum one entity listed in paragraph (1). (c) Application.--To be eligible to receive a grant under this section, 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. (d) Prioritization.--In awarding grants under subsection (a), the Secretary shall give priority to an eligible entity that is operating in an area with-- (1) high rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; and (2) a high poverty rate. (e) Activities.--An eligible entity that receives a grant under this section may use the grant to address social determinants of maternal health such as-- (1) housing; (2) transportation; (3) nutrition; (4) employment, workplace conditions, and other economic factors; (5) environmental conditions; (6) intimate partner violence; and (7) other nonclinical factors that impact maternal health outcomes. (f) Technical Assistance.--The Secretary shall provide to grant recipients under this section technical assistance to plan for sustaining programs to address social determinants of maternal health after the period of the grant. (g) Reporting.-- (1) Grantees.--Not later than 1 year after an eligible entity first receives a grant under this section, 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, primary language, geography, socioeconomic status, and other relevant factors. (2) Secretary.--Not later than the end of fiscal year 2031, the Secretary shall submit to Congress a report that includes-- (A) a summary of the reports under paragraph (1); and (B) recommendations for future Federal grant allocations to address social determinants of maternal health. (h) Authorization of Appropriations.--There is authorized to be appropriated to carry out this section $100,000,000 for each of fiscal years 2027 through 2031.

TITLE II--EXTENDING WIC FOR NEW MOMS

SEC. 201. EXTENDING WIC ELIGIBILITY FOR NEW MOMS.

(a) Extension of Postpartum Period.--Section 17(b)(10) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)(10)) is amended by striking ``six months'' and inserting ``24 months''. (b) Extension of Breastfeeding Period.--Section 17(d)(3)(A)(ii) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(d)(3)(A)(ii)) is amended by striking ``1 year'' and inserting ``24 months''. (c) Report.--Not later than 2 years after the date of the enactment of this section, the Secretary shall submit to Congress a report that includes an evaluation of the effect of each of the amendments made by this section on-- (1) maternal and infant health outcomes, including racial and ethnic disparities with respect to such outcomes; (2) breastfeeding rates among postpartum individuals; (3) qualitative evaluations of family experiences under the special supplemental nutrition program under section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786); and (4) other relevant information as determined by the Secretary.

TITLE III--HONORING KIRA JOHNSON

SEC. 301. SUSTAINED FUNDING FOR COMMUNITY-BASED ORGANIZATIONS TO ADVANCE MATERNAL HEALTH EQUITY.

(a) In General.--The Secretary of Health and Human Services (in this section referred to as the ``Secretary'') shall award grants to eligible entities to establish or expand programs to advance maternal health equity. (b) Timing.--Following the 1-year period described in subsection (d), the Secretary shall commence awarding the grants authorized by subsection (a). (c) Eligible Entities.--To be eligible to seek a grant under this section, an entity shall be a community-based organization offering programs and resources aligned with evidence-based practices for improving maternal health outcomes for demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes. (d) Outreach and Technical Assistance Period.--During the 1-year period beginning on the date of enactment of this Act, the Secretary shall-- (1) conduct outreach to encourage eligible entities to apply for grants under this section; and (2) provide technical assistance to eligible entities on best practices for applying for grants under this section. (e) Special Consideration.-- (1) Outreach.--In conducting outreach under subsection (d), the Secretary shall give special consideration to eligible entities that-- (A) are based in, and provide support for, communities with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, to the extent such data are available; (B) are led by individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; and (C) offer programs and resources that are aligned with evidence-based practices for improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes. (2) Awards.--In awarding grants under this section, the Secretary shall give special consideration to eligible entities that-- (A) are described in subparagraphs (A), (B), and (C) of paragraph (1); (B) offer programs and resources designed in consultation with and intended for individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; (C) offer programs and resources in the communities in which the respective eligible entities are located that-- (i) promote maternal mental health and maternal substance use disorder treatments and supports that are aligned with evidence-based practices for improving maternal mental and behavioral health outcomes for individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; (ii) address social determinants of maternal health; (iii) promote evidence-based health literacy and pregnancy, childbirth, and parenting education; (iv) provide support from perinatal health workers; (v) provide culturally and linguistically congruent training to perinatal health workers; (vi) conduct or support research on maternal health issues disproportionately impacting individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes; (vii) offer group prenatal care or group postpartum care; (viii) coordinate mutual aid efforts during infant formula shortages, including community milk depots, donor human milk banks and exchanges, and forums for community outreach and education; (ix) provide support to individuals or family members of individuals who suffered a pregnancy loss, pregnancy-associated death, or pregnancy-related death; or (x) operate midwifery practices that provide culturally and linguistically congruent maternal health care and support, including for the purposes of-- (I) supporting additional education, training, and certification programs, including support for distance learning; (II) providing financial support to current and future midwives to address education costs, debts, and other needs; (III) clinical site investments; (IV) supporting preceptor development trainings; (V) expanding the midwifery practice; or (VI) related needs identified by the midwifery practice and described in the practice's application; and (D) have developed other programs and resources that address community-specific needs for pregnant and postpartum individuals and are aligned with evidence- based practices for improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes. (f) Technical Assistance.--The Secretary shall provide to grant recipients under this section technical assistance on-- (1) capacity building to establish or expand programs to advance maternal health equity; (2) best practices in data collection, measurement, evaluation, and reporting; and (3) planning for sustaining programs to advance maternal health equity after the period of the grant. (g) Evaluation.--Not later than the end of fiscal year 2031, the Secretary shall submit to the Congress an evaluation of the grant program under this section that-- (1) assesses the effectiveness of outreach efforts during the application process in diversifying the pool of grant recipients; (2) makes recommendations for future outreach efforts to diversify the pool of grant recipients for Department of Health and Human Services grant programs and funding opportunities related to maternal health; (3) assesses the effectiveness of programs funded by grants under this section in improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, to the extent practicable; and (4) makes recommendations for future Department of Health and Human Services grant programs and funding opportunities that deliver funding to community-based organizations that provide programs and resources that are aligned with evidence- based practices for improving maternal health outcomes for individuals from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes. (h) Authorization of Appropriations.--To carry out this section, there is authorized to be appropriated $100,000,000 for each of fiscal years 2027 through 2031.

SEC. 302. RESPECTFUL MATERNITY CARE TRAINING FOR ALL EMPLOYEES IN MATERNITY CARE SETTINGS.

Part B of title VII of the Public Health Service Act (42 U.S.C. 293 et seq.) is amended by adding at the end the following new section:

``SEC. 742. RESPECTFUL MATERNITY CARE TRAINING FOR ALL EMPLOYEES IN MATERNITY CARE SETTINGS.

``(a) Grants.--The Secretary shall award grants for programs to reduce and prevent bias, racism, and discrimination in maternity care settings and to advance respectful, culturally and linguistically congruent, trauma-informed care. ``(b) Special Consideration.--In awarding grants under subsection (a), the Secretary shall give special consideration to applications for programs that would-- ``(1) apply to all maternity care providers and any employees who interact with pregnant and postpartum individuals in the provider setting, including front desk employees, sonographers, schedulers, health care professionals, hospital or health system administrators, security staff, and other employees; ``(2) emphasize periodic, as opposed to one-time, trainings for all birthing professionals and employees described in paragraph (1); ``(3) address implicit bias, racism, and cultural humility; ``(4) be delivered in ongoing education settings for providers maintaining their licenses, with a preference for trainings that provide continuing education units; ``(5) include trauma-informed care best practices and an emphasis on shared decision making between providers and patients; ``(6) include antiracism training and programs; ``(7) be delivered in undergraduate programs that funnel into health professions schools; ``(8) be delivered in settings that apply to providers of the special supplemental nutrition program for women, infants, and children under section 17 of the Child Nutrition Act of 1966; ``(9) integrate bias training in obstetric emergency simulation trainings or related trainings; ``(10) include training for emergency department employees and emergency medical technicians on recognizing warning signs for severe pregnancy-related complications; ``(11) offer training to all maternity care providers on the value of racially, ethnically, and professionally diverse maternity care teams to provide culturally and linguistically congruent care; or ``(12) be based on one or more programs designed by a historically Black college or university or other minority- serving institution. ``(c) Application.--To seek a grant under subsection (a), an entity shall submit an application at such time, in such manner, and containing such information as the Secretary may require. ``(d) Reporting.--Each recipient of a grant under this section shall annually submit to the Secretary a report on the status of activities conducted using the grant, including, as applicable, a description of the impact of training provided through the grant on patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families. ``(e) Best Practices.--Based on the annual reports submitted pursuant to subsection (d), the Secretary-- ``(1) shall produce an annual report on the findings resulting from programs funded through this section; ``(2) shall disseminate such report to all recipients of grants under this section and to the public; and ``(3) may include in such report findings on best practices for improving patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families in maternity care settings. ``(f) Definitions.--In this section: ``(1) The term `postpartum' means the 1-year period beginning on the last day of an individual's pregnancy. ``(2) The term `culturally and linguistically congruent' means in agreement with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other stakeholders. ``(3) The term `racial and ethnic minority group' has the meaning given such term in section 1707(g)(1). ``(g) Authorization of Appropriations.--To carry out this section, there is authorized to be appropriated $5,000,000 for each of fiscal years 2027 through 2031.''.

SEC. 303. STUDY ON REDUCING AND PREVENTING BIAS, RACISM, AND DISCRIMINATION IN MATERNITY CARE SETTINGS.

(a) In General.--The Secretary of Health and Human Services shall seek to enter into an agreement, not later than 90 days after the date of enactment of this Act, with the National Academies of Sciences, Engineering, and Medicine (referred to in this section as the ``National Academies'') under which the National Academies agree to-- (1) conduct a study on the design and implementation of programs to reduce and prevent bias, racism, and discrimination in maternity care settings and to advance respectful, culturally and linguistically congruent, trauma-informed care; and (2) not later than 24 months after the date of enactment of this Act-- (A) complete the study; and (B) transmit a report on the results of the study to the Congress. (b) Possible Topics.--The agreement entered into pursuant to subsection (a) may provide for the study of any of the following: (1) The development of a scorecard or other evaluation standards for programs designed to reduce and prevent bias, racism, and discrimination in maternity care settings to assess the effectiveness of such programs in improving patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families. (2) Determination of the types and frequency of training to reduce and prevent bias, racism, and discrimination in maternity care settings that are demonstrated to improve patient outcomes or patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families.

SEC. 304. RESPECTFUL MATERNITY CARE COMPLIANCE PROGRAM.

(a) In General.--The Secretary of Health and Human Services (referred to in this section as the ``Secretary'') shall award grants to accredited hospitals, health systems, and other maternity care settings to establish as an integral part of quality implementation initiatives within one or more hospitals or other birth settings a respectful maternity care compliance program. (b) Program Requirements.--A respectful maternity care compliance program funded through a grant under this section shall-- (1) institutionalize mechanisms to allow patients receiving maternity care services, the families of such patients, or perinatal health workers supporting such patients to report instances of racism or evidence of bias on the basis of race, ethnicity, or another protected class; (2) institutionalize response mechanisms through which representatives of the program can directly follow up with the patient, if possible, and the patient's family in a timely manner; (3) prepare and make publicly available a hospital- or health system-wide strategy to reduce bias on the basis of race, ethnicity, or another protected class in the delivery of maternity care that includes-- (A) information on the training programs to reduce and prevent bias, racism, and discrimination on the basis of race, ethnicity, or another protected class for all employees in maternity care settings; (B) information on the number of cases reported to the compliance program; and (C) the development of methods to routinely assess the extent to which bias, racism, or discrimination on the basis of race, ethnicity, or another protected class is present in the delivery of maternity care to patients from racial and ethnic minority groups; (4) develop mechanisms to routinely collect and publicly report hospital-level data related to patient-reported experience of care; and (5) provide annual reports to the Secretary with information about each case reported to the compliance program over the course of the year containing such information as the Secretary may require, such as-- (A) deidentified demographic information on the patient in the case, such as race, ethnicity, gender identity, and primary language; (B) the content of the report from the patient or the family of the patient to the compliance program; (C) the response from the compliance program; and (D) to the extent applicable, institutional changes made as a result of the case. (c) Secretary Requirements.-- (1) Processes.--Not later than 180 days after the date of enactment of this Act, the Secretary shall establish processes for-- (A) disseminating best practices for establishing and implementing a respectful maternity care compliance program within a hospital or other birth setting; (B) promoting coordination and collaboration between hospitals, health systems, and other maternity care delivery settings on the establishment and implementation of respectful maternity care compliance programs; and (C) evaluating the effectiveness of respectful maternity care compliance programs on maternal health outcomes and patient and family experiences, especially for patients from racial and ethnic minority groups and their families. (2) Study.-- (A) In general.--Not later than 2 years after the date of enactment of this Act, the Secretary shall, through a contract with an independent research organization, conduct a study on strategies to address-- (i) racism or bias on the basis of race, ethnicity, or another protected class in the delivery of maternity care services; and (ii) successful implementation of respectful care initiatives. (B) Components of study.--The study shall include the following: (i) An assessment of the reports submitted to the Secretary from the respectful maternity care compliance programs pursuant to subsection (b)(5). (ii) Based on such assessment, recommendations for potential accountability mechanisms related to cases of racism or bias on the basis of race, ethnicity, or another protected class in the delivery of maternity care services at hospitals and other birth settings. Such recommendations shall take into consideration medical and nonmedical factors that contribute to adverse patient experiences and maternal health outcomes. (C) Report.--The Secretary shall submit to the Congress and make publicly available a report on the results of the study under this paragraph. (d) Authorization of Appropriations.--To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2027 through 2032.

SEC. 305. GAO REPORT.

(a) In General.--Not later than 2 years after the date of enactment of this Act and annually thereafter, the Comptroller General of the United States shall submit to the Congress and make publicly available a report on the establishment of respectful maternity care compliance programs within hospitals, health systems, and other maternity care settings. (b) Matters Included.--The report under subsection (a) shall include the following: (1) Information regarding the extent to which hospitals, health systems, and other maternity care settings have elected to establish respectful maternity care compliance programs, including-- (A) which hospitals and other birth settings elect to establish compliance programs and when such programs are established; (B) to the extent practicable, impacts of the establishment of such programs on maternal health outcomes and patient and family experiences in the hospitals and other birth settings that have established such programs, especially for patients from racial and ethnic minority groups and their families; (C) information on geographic areas, and types of hospitals or other birth settings, where respectful maternity care compliance programs are not being established and information on factors contributing to decisions to not establish such programs; and (D) recommendations for establishing respectful maternity care compliance programs in geographic areas, and types of hospitals or other birth settings, where such programs are not being established. (2) Whether the funding made available to carry out this section has been sufficient and, if applicable, recommendations for additional appropriations to carry out this section. (3) Such other information as the Comptroller General determines appropriate.

TITLE IV--MATERNAL HEALTH FOR VETERANS

SEC. 401. SUPPORT FOR MATERNITY HEALTH CARE AND COORDINATION PROGRAMS OF THE DEPARTMENT OF VETERANS AFFAIRS.

(a) Report to Congress.--Not later than 1 year after the date of the enactment of this Act, and annually thereafter until September 30, 2031, the Secretary of Veterans Affairs shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate, and make publicly available, a report that contains the following: (1) A summary of the activities carried out under the programs of the Department of Veterans Affairs relating to maternity health care or coordination. (2) Data on maternal health outcomes of veterans who receive care furnished by the Secretary of Veterans Affairs, including pursuant to such programs. (3) Data on patients who are dually eligible to receive assistance from the Department of Veterans Affairs and the Indian Health Service and the maternity health care outcomes associated with receiving such care. (4) Recommendations by the Secretary of Veterans Affairs to improve the maternal health outcomes of veterans, with a particular focus on veterans from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes. (b) Authorization of Appropriations.-- (1) In general.--There is authorized to be appropriated to the Secretary of Veterans Affairs $15,000,000 for each of fiscal years 2027, 2028, 2029, 2030, and 2031, for the programs of the Department of Veterans Affairs relating to maternity care coordination and related programs, including the maternity care coordination program described in Veterans Health Administration Directive 1330.03. (2) Supplement not supplant.--Amounts authorized under paragraph (1) are authorized in addition to any other amounts authorized for maternity health care and coordination for the Department of Veterans Affairs.

TITLE V--PERINATAL WORKFORCE

SEC. 501. HHS AGENCY DIRECTIVES.

(a) Guidance to States.-- (1) In general.--Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall issue and disseminate guidance to States to educate providers, managed care entities, and other insurers about the value and process of delivering respectful maternal health care through diverse and multidisciplinary care provider models. (2) Contents.--The guidance required by paragraph (1) shall address how States can encourage and incentivize hospitals, health systems, midwifery practices, freestanding birth centers, other maternity care provider groups, managed care entities, and other insurers-- (A) to recruit and retain maternity care providers, mental and behavioral health care providers acting in accordance with State law, and registered dietitians or nutrition professionals (as such term is defined in section 1861(vv)(2) of the Social Security Act (42 U.S.C. 1395x(vv)(2)))-- (i) from racially, ethnically, and linguistically diverse backgrounds; (ii) with experience practicing in racially and ethnically diverse communities; and (iii) who have undergone training on implicit bias and racism; (B) to incorporate into maternity care teams-- (i) midwives who meet, at a minimum, the international definition of a midwife and global standards for midwifery education as established by the International Confederation of Midwives; (ii) perinatal health workers; (iii) physician assistants; (iv) advanced practice registered nurses; and (v) lactation consultants certified by the International Board of Lactation Consultant Examiners; (C) to provide collaborative, culturally and linguistically congruent care; and (D) to provide opportunities for individuals enrolled in accredited midwifery education programs to participate in job shadowing with maternity care teams in hospitals, health systems, midwifery practices, and freestanding birth centers. (b) Study on Respectful and Culturally and Linguistically Congruent Maternity Care.-- (1) Study.--The Secretary of Health and Human Services acting through the Director of the National Institutes of Health (in this subsection referred to as the ``Secretary'') shall conduct a study on best practices in respectful and culturally and linguistically congruent maternity care. (2) Report.--Not later than 2 years after the date of enactment of this Act, the Secretary shall-- (A) complete the study required by paragraph (1); (B) submit to the Congress and make publicly available a report on the results of such study; and (C) include in such report-- (i) a compendium of examples of hospitals, health systems, midwifery practices, freestanding birth centers, other maternity care provider groups, managed care entities, and other insurers that are delivering respectful and culturally and linguistically congruent maternal health care; (ii) a compendium of examples of hospitals, health systems, midwifery practices, freestanding birth centers, other maternity care provider groups, managed care entities, and other insurers that have made progress in reducing disparities in maternal health outcomes and improving birthing experiences for pregnant and postpartum individuals from racial and ethnic minority groups; and (iii) recommendations to hospitals, health systems, midwifery practices, freestanding birth centers, other maternity care provider groups, managed care entities, and other insurers, for best practices in respectful and culturally and linguistically congruent maternity care.

SEC. 502. GRANTS TO GROW AND DIVERSIFY THE PERINATAL WORKFORCE.

Title VII of the Public Health Service Act is amended by inserting after section 757 (42 U.S.C. 294f) the following new section:

``SEC. 758. PERINATAL WORKFORCE GRANTS.

``(a) In General.--The Secretary shall award grants to entities to establish or expand programs described in subsection (b) to grow and diversify the perinatal workforce. ``(b) Use of Funds.--Recipients of grants under this section shall use the grants to grow and diversify the perinatal workforce by-- ``(1) establishing accredited schools or programs that provide education and training to individuals seeking appropriate licensing and certification as-- ``(A) physician assistants who will complete clinical training in the field of maternal and perinatal health; ``(B) perinatal health workers; or ``(C) midwives who meet, at a minimum, the international definition of a midwife and global standards for midwifery education as established by the International Confederation of Midwives; and ``(2) expanding the capacity of existing accredited schools or programs described in paragraph (1), for the purposes of increasing the number of students enrolled in such accredited schools or programs, such as by awarding scholarships for students (including students from racially, ethnically, and linguistically diverse backgrounds). ``(c) Prioritization.--In awarding grants under this section, the Secretary shall give priority to a school or program described in subsection (b) that-- ``(1) has demonstrated a commitment to recruiting and retaining students and faculty from racial and ethnic minority groups; ``(2) has developed a strategy to recruit and retain a diverse pool of students into the school or program described in subsection (b) that is supported by funds received through the grant, particularly from racial and ethnic minority groups and other underserved populations; ``(3) has developed a strategy to recruit and retain students who plan to practice in a health professional shortage area designated under section 332; ``(4) has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes, to the extent practicable; and ``(5) includes in the standard curriculum for all students within the school or program described in subsection (b) a bias, racism, or discrimination training program that includes training on implicit bias and racism. ``(d) Reporting.--As a condition on receipt of a grant under this section for a school or program described in subsection (b), an entity shall agree to submit to the Secretary an annual report on the activities conducted through the grant, including-- ``(1) the number and demographics of students participating in the school or program; ``(2) the extent to which students in the school or program are entering careers in-- ``(A) health professional shortage areas designated under section 332; and ``(B) areas with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, to the extent such data are available; and ``(3) whether the school or program has included in the standard curriculum for all students a bias, racism, or discrimination training program that includes explicit and implicit bias, and if so the effectiveness of such training program. ``(e) Period of Grants.--The period of a grant under this section shall be up to 5 years. ``(f) Application.--To seek a grant under this section, 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 any information necessary for prioritization under subsection (c). ``(g) Technical Assistance.--The Secretary shall provide, directly or by contract, technical assistance to entities seeking or receiving a grant under this section on the development, use, evaluation, and postgrant period sustainability of the school or program described in subsection (b) that is proposed to be, or is being, established or expanded through the grant. ``(h) Report by the Secretary.--Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and submit to the Congress, and post on the internet website of the Department of Health and Human Services, a report on the effectiveness of the grant program under this section at-- ``(1) recruiting students from racial and ethnic minority groups; ``(2) increasing the number of health professionals described in subparagraphs (A), (B), and (C) of subsection (b)(1) from racial and ethnic minority groups and other underserved populations; ``(3) increasing the number of such health professionals working in health professional shortage areas designated under section 332; and ``(4) increasing the number of such health professionals working in areas with significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available. ``(i) Definition.--In this section, the term `racial and ethnic minority group' has the meaning given such term in section 1707(g)(1). ``(j) Authorization of Appropriations.--To carry out this section, there is authorized to be appropriated $15,000,000 for each of fiscal years 2027 through 2031.''.

SEC. 503. GRANTS TO GROW AND DIVERSIFY THE NURSING WORKFORCE IN MATERNAL AND PERINATAL HEALTH.

Title VIII of the Public Health Service Act is amended by inserting after section 811 of that Act (42 U.S.C. 296j) the following:

``SEC. 812. PERINATAL NURSING WORKFORCE GRANTS.

``(a) In General.--The Secretary shall award grants to schools of nursing to grow and diversify the perinatal nursing workforce. ``(b) Use of Funds.--Recipients of grants under this section shall use the grants to grow and diversify the perinatal nursing workforce by providing scholarships to students seeking to become-- ``(1) nurse practitioners whose education includes a focus on maternal and perinatal health; ``(2) certified nurse-midwives; or ``(3) clinical nurse specialists whose education includes a focus on maternal and perinatal health. ``(c) Prioritization.--In awarding grants under this section, the Secretary shall give priority to any school of nursing that-- ``(1) has developed a strategy to recruit and retain a diverse pool of students seeking to enter careers focused on maternal and perinatal health, particularly students from racial and ethnic minority groups and other underserved populations; ``(2) has developed a partnership with a practice setting in a health professional shortage area designated under section 332 for the clinical placements of the school's students; ``(3) has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic disparities in maternal health outcomes, to the extent practicable; and ``(4) includes in the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health a bias, racism, or discrimination training program that includes education on implicit bias and racism. ``(d) Reporting.--As a condition on receipt of a grant under this section, a school of nursing shall agree to submit to the Secretary an annual report on the activities conducted through the grant, including, to the extent practicable-- ``(1) the number and demographics of students in the school of nursing seeking to enter careers focused on maternal and perinatal health; ``(2) the extent to which such students are preparing to enter careers in-- ``(A) health professional shortage areas designated under section 332; and ``(B) areas with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or other adverse perinatal or childbirth outcomes, to the extent such data are available; and ``(3) whether the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health includes a bias, racism, or discrimination training program that includes education on implicit bias and racism. ``(e) Period of Grants.--The period of a grant under this section shall be up to 5 years. ``(f) Application.--To seek a grant under this section, 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 any information necessary for prioritization under subsection (c). ``(g) Technical Assistance.--The Secretary shall provide, directly or by contract, technical assistance to schools of nursing seeking or receiving a grant under this section on the processes of awarding and evaluating scholarships through the grant. ``(h) Report by the Secretary.--Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and submit to the Congress, and post on the internet website of the Department of Health and Human Services, a report on the effectiveness of the grant program under this section at-- ``(1) recruiting students from racial and ethnic minority groups and other underserved populations; ``(2) increasing the number of advanced practice registered nurses entering careers focused on maternal and perinatal health from racial and ethnic minority groups and other underserved populations; ``(3) increasing the number of advanced practice registered nurses entering careers focused on maternal and perinatal health working in health professional shortage areas designated under section 332; and ``(4) increasing the number of advanced practice registered nurses entering careers focused on maternal and perinatal health working in areas with significant racial and ethnic disparities in maternal health outcomes, to the extent such data are available. ``(i) Authorization of Appropriations.--To carry out this section, there is authorized to be appropriated $15,000,000 for each of fiscal years 2027 through 2031.''.

SEC. 504. GAO REPORT.

(a) In General.--Not later than 2 years after the date of enactment of this Act and every 5 years thereafter, the Comptroller General of the United States shall submit to Congress a report on barriers to maternal health education and access to care in the United States. Such report shall include the information and recommendations described in subsection (b). (b) Content of Report.--The report under subsection (a) shall include-- (1) an assessment of current barriers to entering and successfully completing accredited midwifery education programs, and recommendations for addressing such barriers, particularly for low-income women and women from racial and ethnic minority groups; (2) an assessment of current barriers to entering and successfully completing accredited education programs for other health professional careers related to maternity care, including maternity care providers, mental and behavioral health care providers acting in accordance with State law, and registered dietitians or nutrition professionals (as such term is defined in section 1861(vv)(2) of the Social Security Act (42 U.S.C. 1395x(vv)(2))), particularly for low-income women and women from racial and ethnic minority groups; (3) an assessment of current barriers that prevent midwives from meeting the international definition of a midwife and global standards for midwifery education as established by the International Confederation of Midwives, and recommendations for addressing such barriers, particularly for low-income women and women from racial and ethnic minority groups; (4) an assessment of disparities in access to maternity care providers, mental or behavioral health care providers acting in accordance with State law, and registered dietitians or nutrition professionals (as such term is defined in section 1861(vv)(2) of the Social Security Act (42 U.S.C. 1395x(vv)(2))), and perinatal health workers, stratified by race, ethnicity, gender identity, primary language, geographic location, and insurance type and recommendations to promote greater access equity; and (5) recommendations to promote greater equity in compensation for perinatal health workers under public and private insurers, particularly for such individuals from racially and ethnically diverse backgrounds.

TITLE VI--DATA TO SAVE MOMS

SEC. 601. FUNDING FOR MATERNAL MORTALITY REVIEW

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