Perinatal Workforce Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 6164 To grow and diversify the perinatal workforce, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 10, 2020 Ms. MOORE (for herself, Ms. UNDERWOOD, Ms. ADAMS, Ms. SEWELL of Ala- bama, Ms. NORTON, Ms. SCANLON, Mr. CLAY, Mr. KHANNA, Ms. PRESSLEY, and Mr. LAWSON of Florida) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To grow and diversify the perinatal workforce, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Perinatal Workforce Act of 2020’’. 5 (b) TABLE OF CONTENTS.—The table of contents of 6 this Act is as follows: 7 Sec. 1. Short title; table of contents. Sec. 2. HHS agency directives. Sec. 3. Grants to grow and diversify the perinatal workforce. Sec. 4. Grants to grow and diversify the nursing workforce in maternal and perinatal health. Sec. 5. GAO report on barriers to maternity care. VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6211 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 6164 IH SEC. 2. HHS AGENCY DIRECTIVES. 1 (a) GUIDANCE TO STATES.— 2 (1) IN GENERAL.—Not later than 2 years after 3 the date of enactment of this Act, the Secretary of 4 Health and Human Services shall issue and dissemi- 5 nate guidance to States to educate providers and 6 managed care entities about the value and process of 7 delivering respectful maternal health care through 8 diverse care provider models. 9 (2) CONTENTS.—The guidance required by 10 paragraph (1) shall address how States can encour- 11 age and incentivize hospitals, health systems, free- 12 standing birth centers, other maternity care provider 13 groups, and managed care entities— 14 (A) to recruit and retain maternity care 15 providers, such as obstetrician-gynecologists, 16 family physicians, physician assistants, mid- 17 wives who meet at a minimum the international 18 definition of the midwife and global standards 19 for midwifery education as established by the 20 International Confederation of Midwives, nurse 21 practitioners, and clinical nurse specialists— 22 (i) from racially and ethnically diverse 23 backgrounds; 24 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 6164 IH (ii) with experience practicing in ra- 1 cially and ethnically diverse communities; 2 and 3 (iii) who have undergone trainings on 4 implicit and explicit bias and racism; 5 (B) to incorporate into maternity care 6 teams midwives who meet at a minimum the 7 international definition of the midwife and glob- 8 al standards for midwifery education as estab- 9 lished by the International Confederation of 10 Midwives, doulas, community health workers, 11 peer supporters, certified lactation consultants, 12 nutritionists and dietitians, social workers, 13 home visitors, and navigators; 14 (C) to provide collaborative, culturally con- 15 gruent care; and 16 (D) to provide opportunities for individuals 17 enrolled in accredited midwifery education pro- 18 grams to participate in job shadowing with ma- 19 ternity care teams in hospitals, health systems, 20 and freestanding birth centers. 21 (b) STUDY ON CULTURALLY CONGRUENT MATER- 22 NITY CARE.— 23 (1) STUDY.—The Secretary of Health and 24 Human Services acting through the Director of the 25 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 6164 IH National Institutes of Health (in this subsection re- 1 ferred to as the ‘‘Secretary’’) shall conduct a study 2 on best practices in culturally congruent maternity 3 care. 4 (2) REPORT.—Not later than 2 years after the 5 date of enactment of this Act, the Secretary shall— 6 (A) complete the study required by para- 7 graph (1); 8 (B) submit to the Congress and make pub- 9 licly available a report on the results of such 10 study; and 11 (C) include in such report— 12 (i) a compendium of examples of hos- 13 pitals, health systems, freestanding birth 14 centers, other maternity care provider 15 groups, and managed care entities that are 16 delivering culturally congruent maternal 17 health care; 18 (ii) a compendium of examples of hos- 19 pitals, health systems, freestanding birth 20 centers, other maternity care provider 21 groups, and managed care entities that 22 have low levels of racial and ethnic dispari- 23 ties in maternal health outcomes; and 24 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 6164 IH (iii) recommendations to hospitals, 1 health systems, freestanding birth centers, 2 other maternity care provider groups, and 3 managed care entities for best practices in 4 culturally congruent maternity care. 5 (c) DEFINITION.—In this section, the term ‘‘cul- 6 turally congruent’’, with respect to care or maternity care, 7 means care that is in agreement with the preferred cul- 8 tural values, beliefs, worldview, and practices of the health 9 care consumer and other stakeholders. 10 SEC. 3. GRANTS TO GROW AND DIVERSIFY THE PERINATAL 11 WORKFORCE. 12 Title VII of the Public Health Service Act is amended 13 by inserting after section 757 (42 U.S.C. 294f) the fol- 14 lowing new section: 15 ‘‘SEC. 758. PERINATAL WORKFORCE GRANTS. 16 ‘‘(a) IN GENERAL.—The Secretary may award grants 17 to entities to establish or expand programs described in 18 subsection (b) to grow and diversify the perinatal work- 19 force. 20 ‘‘(b) USE OF FUNDS.—Recipients of grants under 21 this section shall use the grants to grow and diversify the 22 perinatal workforce by— 23 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 6164 IH ‘‘(1) establishing schools or programs that pro- 1 vide education and training to individuals seeking 2 appropriate licensing or certification as— 3 ‘‘(A) physician assistants who will complete 4 clinical training in the field of maternal and 5 perinatal health; and 6 ‘‘(B) other perinatal health workers such 7 as doulas, community health workers, peer sup- 8 porters, certified lactation consultants, nutri- 9 tionists and dietitians, social workers, home 10 visitors, and navigators; and 11 ‘‘(2) expanding the capacity of existing schools 12 or programs described in paragraph (1), for the pur- 13 poses of increasing the number of students enrolled 14 in such schools or programs, including by awarding 15 scholarships for students. 16 ‘‘(c) PRIORITIZATION.—In awarding grants under 17 this section, the Secretary shall give priority to any insti- 18 tution of higher education that— 19 ‘‘(1) has demonstrated a commitment to re- 20 cruiting and retaining minority students, particu- 21 larly from demographic groups experiencing high 22 rates of maternal mortality and severe maternal 23 morbidity; 24 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 6164 IH ‘‘(2) has developed a strategy to recruit and re- 1 tain a diverse pool of students into the perinatal 2 workforce program or school supported by funds re- 3 ceived through the grant, particularly from demo- 4 graphic groups experiencing high rates of maternal 5 mortality and severe maternal morbidity; 6 ‘‘(3) has developed a strategy to recruit and re- 7 tain students who plan to practice in a health pro- 8 fessional shortage area designated under section 9 332; 10 ‘‘(4) has developed a strategy to recruit and re- 11 tain students who plan to practice in an area with 12 significant racial and ethnic disparities in maternal 13 health outcomes; and 14 ‘‘(5) includes in the standard curriculum for all 15 students within the perinatal workforce program or 16 school a bias, racism, or discrimination training pro- 17 gram that includes training on explicit and implicit 18 bias. 19 ‘‘(d) REPORTING.—As a condition on receipt of a 20 grant under this section for a perinatal workforce program 21 or school, an entity shall agree to submit to the Secretary 22 an annual report on the activities conducted through the 23 grant, including— 24 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 6164 IH ‘‘(1) the number and demographics of students 1 participating in the program or school; 2 ‘‘(2) the extent to which students in the pro- 3 gram or school are entering careers in— 4 ‘‘(A) health professional shortage areas 5 designated under section 332; and 6 ‘‘(B) areas with significant racial and eth- 7 nic disparities in maternal health outcomes; and 8 ‘‘(3) whether the program or school has in- 9 cluded in the standard curriculum for all students a 10 bias, racism, or discrimination training program that 11 includes explicit and implicit bias, and if so the ef- 12 fectiveness of such training program. 13 ‘‘(e) PERIOD OF GRANTS.—The period of a grant 14 under this section shall be up to 5 years. 15 ‘‘(f) APPLICATION.—To seek a grant under this sec- 16 tion, an entity shall submit to the Secretary an application 17 at such time, in such manner, and containing such infor- 18 mation as the Secretary may require, including any infor- 19 mation necessary for prioritization under subsection (c). 20 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 21 provide, directly or by contract, technical assistance to in- 22 stitutions of higher education seeking or receiving a grant 23 under this section on the development, use, evaluation, 24 and post-grant period sustainability of the perinatal work- 25 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 6164 IH force programs or schools proposed to be, or being, estab- 1 lished or expanded through the grant. 2 ‘‘(h) REPORT BY SECRETARY.—Not later than 4 3 years after the date of enactment of this section, the Sec- 4 retary shall prepare and submit to the Congress, and post 5 on the internet website of the Department of Health and 6 Human Services, a report on the effectiveness of the grant 7 program under this section at— 8 ‘‘(1) recruiting minority students, particularly 9 from demographic groups experiencing high rates of 10 maternal mortality and severe maternal morbidity; 11 ‘‘(2) increasing the number of physician assist- 12 ants who will complete clinical training in the field 13 of maternal and perinatal health, and other 14 perinatal health workers, from demographic groups 15 experiencing high rates of maternal mortality and 16 severe maternal morbidity; 17 ‘‘(3) increasing the number of physician assist- 18 ants who will complete clinical training in the field 19 of maternal and perinatal health, and other 20 perinatal health workers, working in health profes- 21 sional shortage areas designated under section 332; 22 and 23 ‘‘(4) increasing the number of physician assist- 24 ants who will complete clinical training in the field 25 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 6164 IH of maternal and perinatal health, and other 1 perinatal health workers, working in areas with sig- 2 nificant racial and ethnic disparities in maternal 3 health outcomes. 4 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—To 5 carry out this section, there is authorized to be appro- 6 priated $15,000,000 for each of fiscal years 2021 through 7 2025.’’. 8 SEC. 4. GRANTS TO GROW AND DIVERSIFY THE NURSING 9 WORKFORCE IN MATERNAL AND PERINATAL 10 HEALTH. 11 Title VIII of the Public Health Service Act is amend- 12 ed by inserting after section 811 of that Act (42 U.S.C. 13 296j) the following: 14 ‘‘SEC. 812. PERINATAL NURSING WORKFORCE GRANTS. 15 ‘‘(a) IN GENERAL.—The Secretary may award grants 16 to schools of nursing to grow and diversify the perinatal 17 nursing workforce. 18 ‘‘(b) USE OF FUNDS.—Recipients of grants under 19 this section shall use the grants to grow and diversify the 20 perinatal nursing workforce by providing scholarships to 21 students seeking to become— 22 ‘‘(1) nurse practitioners whose education in- 23 cludes a focus on maternal and perinatal health; or 24 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 6164 IH ‘‘(2) clinical nurse specialists whose education 1 includes a focus on maternal and perinatal health. 2 ‘‘(c) PRIORITIZATION.—In awarding grants under 3 this section, the Secretary shall give priority to any school 4 of nursing that— 5 ‘‘(1) has developed a strategy to recruit and re- 6 tain a diverse pool of students seeking to enter ca- 7 reers focused on maternal and perinatal health; 8 ‘‘(2) has developed a partnership with a prac- 9 tice setting in a health professional shortage area 10 designated under section 332 for the clinical place- 11 ments of the school’s students; 12 ‘‘(3) has developed a strategy to recruit and re- 13 tain students who plan to practice in an area with 14 significant racial and ethnic disparities in maternal 15 health outcomes; and 16 ‘‘(4) includes in the standard curriculum for all 17 students seeking to enter careers focused on mater- 18 nal and perinatal health a bias, racism, or discrimi- 19 nation training program that includes education on 20 explicit and implicit bias. 21 ‘‘(d) REPORTING.—As a condition on receipt of a 22 grant under this section, a school of nursing shall agree 23 to submit to the Secretary an annual report on the activi- 24 VerDate Sep 11 2014 03:42 Mar 14, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H6164.IH H6164 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 6164 IH ties conducted through the grant, including, to the extent 1 practicable— 2 ‘‘(1) the number and demographics of students 3 in the school of nursing seeking to enter careers fo- 4 cused on maternal and perinatal health; 5 ‘‘(2) the extent to which such students are pre- 6 paring to enter careers in— 7 ‘‘(A) health professional shortage areas 8 designated under section 332; and 9 ‘‘(B) areas with significant racial and eth- 10 nic disparities in maternal health outcomes; and 11 ‘‘(3) whether the standard curriculum for all 12 students seeking to enter careers focused on mater- 13 [Text truncated for display. 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