H.R. 7973 — Momnibus Act

This section directs the Secretary of Health and Human Services (HHS) to convene a Task Force to develop strategies and coordinate federal agencies and stakeholders in eliminating preventable maternal mortality, severe maternal morbidity, and maternal health disparities, including clinical and nonclinical causes. The Task Force includes 17 specified ex officio members (or designees) from HHS components (e.g., Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention), other HHS offices, and departments including Housing and Urban Development, Transportation, Agriculture, Labor, Environmental Protection Agency, and Justice (Office on Violence Against Women); HHS may also appoint additional members representing patients, community-based organizations focused on disparities (with priority to leaders from high-risk demographic groups), Indian health care and Tribal Epidemiology Centers, perinatal health workers, maternity care providers, and other maternal health stakeholders. HHS selects the chair from Task Force members. The Task Force may address topics including barriers to prenatal/postpartum care and social determinants of health (e.g., housing, food deserts, environmental risks, childcare, domestic violence). Not later than two years after enactment and annually thereafter, the Task Force must submit to Congress and publish on the HHS website a report on its coordination efforts, agency actions, and federal funding recommendations. (As background, federal advisory committees such as this Task Force are subject to the Federal Advisory Committee Act (5 U.S.C. ch. 10) and terminate after two years unless renewed, with required charter filings.)

This section directs the Secretary of Health and Human Services to award grants to eligible entities—such as community-based organizations, Indian Tribes or Tribal organizations, Urban Indian organizations, public health departments, nonprofits working with such entities, or consortia including at least one such entity—to address social determinants of maternal health (e.g., housing, transportation, nutrition, employment, environmental conditions, intimate partner violence, and other nonclinical factors) in order to eliminate maternal mortality, severe maternal morbidity, and maternal health disparities, with priority for high-risk, high-poverty areas. The section requires technical assistance for grant recipients to sustain programs post-grant; annual grantee reports with disaggregated data on activities and effects (by race, ethnicity, etc.); and a Secretary report to Congress by the end of FY2031 summarizing grantee reports and recommending future grant allocations. The section authorizes $100 million for each of FY2027 through FY2031.

This section extends postpartum eligibility under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to 24 months (from 6 months) and breastfeeding duration to 24 months (from 1 year). (Thus, WIC—which provides supplemental foods and nutrition education to at-risk pregnant, postpartum, and breastfeeding women, infants, and young children—may serve more postpartum women and support extended breastfeeding.) It further directs the Secretary to submit to Congress, not later than two years after enactment, a report evaluating the effects of these changes on (1) maternal and infant health outcomes, including racial and ethnic disparities; (2) breastfeeding rates among postpartum individuals; (3) qualitative evaluations of family experiences in WIC; and (4) other relevant information determined by the Secretary.

This section establishes a grant program under which the Secretary of Health and Human Services (HHS) awards grants to community-based organizations to establish or expand evidence-based programs advancing maternal health equity for demographic groups with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or adverse perinatal or childbirth outcomes. Awards commence after a 1-year outreach and technical assistance period beginning on the date of enactment, during which HHS prioritizes entities in high-risk communities, led by affected individuals, and offering specified programs (e.g., maternal mental health and substance use disorder support, addressing social determinants of health, health literacy education, perinatal health worker support, group prenatal/postpartum care, midwifery practices, and pregnancy loss support). In awarding grants, HHS gives special consideration to such entities and provides ongoing technical assistance on capacity building, data practices, and program sustainability; by the end of FY2031, HHS must evaluate the program's effectiveness in diversifying recipients and improving outcomes, with recommendations for future maternal health funding.

This section establishes a grant program under the Public Health Service Act to fund programs that reduce and prevent bias, racism, and discrimination in maternity care settings and advance respectful, culturally and linguistically congruent, trauma-informed care for pregnant and postpartum individuals (defined as the one-year period beginning on the last day of pregnancy). In awarding grants, the Secretary of Health and Human Services must give special consideration to programs that (1) apply to all maternity care providers and employees interacting with pregnant and postpartum individuals (e.g., front desk staff, sonographers, administrators, security); (2) emphasize periodic trainings; (3) address implicit bias, racism, and cultural humility; (4) are delivered in continuing education settings (preferring those offering continuing education units); (5) include trauma-informed care and shared decision making; (6) incorporate antiracism training; (7) are delivered in undergraduate health professions pipeline programs; (8) apply to WIC providers; (9) integrate bias training into obstetric emergency simulations; (10) train emergency department staff and EMTs on severe pregnancy-related complications; (11) emphasize diverse maternity care teams; or (12) are based on programs from historically Black colleges or universities or other minority-serving institutions. Grant recipients must submit annual reports to the Secretary on activities and impacts on patient outcomes and experiences, particularly for racial and ethnic minority groups, based on which the Secretary must produce and publicly disseminate annual reports that may identify best practices. The section authorizes $5 million for each of FY2027 through FY2031.

This section directs the Secretary of Health and Human Services to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine, not later than 90 days after enactment, under which the Academies 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 transmit a report to Congress not later than 24 months after enactment. The agreement may provide for the study to address (1) development of a scorecard or other evaluation standards to assess the effectiveness of such programs in improving patient outcomes and experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families, and (2) determination of the types and frequency of training demonstrated to improve such outcomes or experience.

This section directs the Secretary of Health and Human Services to award grants to accredited hospitals, health systems, and other maternity care settings to establish respectful maternity care compliance programs as part of quality initiatives. Such programs must (1) create reporting mechanisms for patients, families, or perinatal workers to report racism or bias based on race, ethnicity, or another protected class; (2) provide timely follow-up responses; (3) develop and publicly release a strategy to reduce such bias, including staff training, reported case numbers, and bias assessment methods; (4) collect and publicly report patient experience data; and (5) submit annual reports to the Secretary with deidentified case details such as patient demographics, report content, responses, and resulting changes. The section further requires the Secretary, within 180 days of enactment, to establish processes for disseminating best practices, promoting coordination among settings, and evaluating program effectiveness on maternal health outcomes and experiences, particularly for racial and ethnic minorities. Not later than two years after enactment, the Secretary must contract with an independent research organization to study strategies addressing racism or bias in maternity care, assess grantee reports, and recommend accountability mechanisms, with results reported to Congress and publicly released. The section authorizes appropriations of such sums as necessary for FY2027 through FY2032.

This section directs the Comptroller General of the United States to submit to Congress, and make publicly available, a report on the establishment of respectful maternity care compliance programs (i.e., programs ensuring respectful treatment during maternity care, with a focus on reducing disparities for racial and ethnic minorities) within hospitals, health systems, and other maternity care settings not later than two years after the date of enactment of this Act and annually thereafter. The report must include (1) the extent of program establishment, including participating entities and timelines, impacts on maternal health outcomes and patient experiences (especially for racial and ethnic minorities), nonparticipating areas or settings and contributing factors, and recommendations for broader adoption; (2) an assessment of whether funding for these programs has been sufficient, with recommendations for additional appropriations if needed; and (3) other information as determined appropriate by the Comptroller General.

This section directs the Secretary of Veterans Affairs to submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate, and make publicly available, a report not later than one year after enactment of this Act and annually thereafter through September 30, 2031, summarizing (1) activities under Department of Veterans Affairs (VA) maternity health care and coordination programs; (2) maternal health outcomes data for veterans receiving VA-furnished care, including pursuant to such programs; (3) such data for patients dually eligible for VA and Indian Health Service assistance; and (4) recommendations to improve maternal health outcomes for veterans, particularly from demographic groups with elevated rates of maternal mortality, severe maternal morbidity, or other adverse perinatal or childbirth outcomes. This section authorizes appropriations of $15 million for each of fiscal years 2027 through 2031 for VA maternity care coordination and related programs (including the maternity care coordination program described in Veterans Health Administration Directive 1330.03), in addition to other authorized amounts for such purposes.

This section directs the Secretary of Health and Human Services (HHS), not later than two years after the date of enactment, to issue and disseminate guidance to states educating providers, managed care entities, and other insurers on delivering respectful maternal health care through diverse and multidisciplinary care provider models. The guidance addresses how states can encourage and incentivize such entities to (1) recruit and retain racially, ethnically, and linguistically diverse maternity care providers (including those with experience in diverse communities and training on implicit bias and racism), mental and behavioral health providers, and registered dietitians or nutrition professionals; (2) incorporate midwives meeting International Confederation of Midwives standards, perinatal health workers, physician assistants, advanced practice registered nurses, and International Board of Lactation Consultant Examiners-certified lactation consultants; (3) provide collaborative, culturally and linguistically congruent care; and (4) offer job shadowing opportunities to midwifery students. Separately, this section directs the HHS Secretary, acting through the National Institutes of Health Director, to conduct a study on best practices in respectful and culturally and linguistically congruent maternity care and, not later than two years after enactment, submit to Congress and publicly release a report including compendia of exemplary entities and those reducing maternal health disparities among racial and ethnic minorities, along with best practice recommendations.

This section establishes a perinatal workforce grants program under which the Secretary of Health and Human Services awards grants to eligible entities to establish accredited schools or programs training physician assistants in maternal and perinatal health, perinatal health workers, or midwives meeting International Confederation of Midwives standards, or to expand existing programs (e.g., via scholarships to increase enrollment of students from racially, ethnically, and linguistically diverse backgrounds). In awarding grants (up to five years), the Secretary prioritizes applicants demonstrating commitments to recruiting and retaining minority students and faculty, serving health professional shortage areas or maternal health disparity areas, and incorporating bias, racism, and discrimination training (including implicit bias); recipients must submit annual reports on student demographics, career placements, and training effectiveness, with the Secretary required to provide technical assistance and submit a report to Congress four years after enactment evaluating program outcomes. The section authorizes $15 million for each of FY2027 through FY2031.

This section establishes a new grant program under section 812 of the Public Health Service Act to enable schools of nursing to provide scholarships for students training to become nurse practitioners, certified nurse-midwives, or clinical nurse specialists focused on maternal and perinatal health. In awarding grants (up to five years), the Secretary of Health and Human Services must prioritize schools of nursing that (1) recruit and retain diverse students, particularly from racial and ethnic minority groups and other underserved populations, for maternal and perinatal health careers; (2) partner with practice settings in health professional shortage areas for student clinical placements; (3) recruit students to practice in areas with significant racial and ethnic maternal health disparities, to the extent practicable; and (4) include bias, racism, or discrimination training (covering implicit bias and racism) in relevant curricula. Grant recipients must submit annual reports on student demographics and career plans (e.g., in shortage areas or high-disparity regions), curriculum training, and program activities; the Secretary must provide technical assistance and submit a report to Congress four years after enactment evaluating the program's effectiveness in diversifying and directing the perinatal nursing workforce; and $15 million is authorized for each of FY2027 through FY2031. (As background, Title VIII programs support advanced nursing education and practice, including for nurse practitioners, midwives, and clinical nurse specialists, to address workforce shortages.)

This section requires the Comptroller General of the United States to submit to Congress, not later than two years after the date of enactment and every five years thereafter, a report assessing barriers to maternal health education and access to care in the United States. The report must include (1) an assessment of barriers to entering and completing accredited midwifery education programs, with recommendations, particularly for low-income women and women from racial and ethnic minority groups; (2) a similar assessment for education programs for other maternity care-related health professionals (i.e., maternity care providers, mental and behavioral health care providers acting in accordance with state law, and registered dietitians or nutrition professionals); (3) an assessment of barriers preventing U.S. midwives from meeting international midwifery standards, with recommendations; (4) an assessment of disparities in access to such providers and perinatal health workers, stratified by race, ethnicity, gender identity, primary language, geographic location, and insurance type, with recommendations for greater equity; and (5) recommendations to promote equity in compensation for perinatal health workers under public and private insurers, particularly for those from racially and ethnically diverse backgrounds.

This section authorizes $10 million for each of FY2027 through 2031, in addition to amounts under subsection (f), for grants to maternal mortality review committees (MMRCs) of states, Indian Tribes, Tribal organizations, or Urban Indian organizations to (1) select diverse community members for committee membership by prioritizing race/ethnicity, location, maternal mortality experiences, and nonclinical backgrounds and addressing participation barriers (e.g., training, transportation, compensation) using reserved funds under subsection (f); (2) conduct outreach and engagement in communities, focusing on racial and ethnic minority women; and (3) issue public reports assessing review processes' sensitivity to minority circumstances and the funds' impact on diversity and engagement. The section further requires the Secretary to provide technical assistance to grant recipients on best practices for committee diversity and community engagement. This section also requires reservation of not less than $1.5 million of amounts available under subsection (f) for grants to Indian Tribes, Tribal organizations, or Urban Indian organizations. (MMRCs investigate pregnancy-related deaths to identify causes, prevention strategies, and health system improvements, with disparities disproportionately affecting racial and ethnic minorities.)

This section expands the required activities of state maternal mortality review committees by inserting three new requirements—(1) reviewing cases of severe maternal morbidity using the most up-to-date indicators; (2) reviewing deaths during pregnancy or within one year postpartum from suicide, overdose, or other mental health or substance use disorder deaths attributed to or aggravated by pregnancy or childbirth complications; and (3) consulting with local community-based organizations representing pregnant and postpartum individuals from demographic groups at elevated risk of maternal mortality, severe maternal morbidity, or related disparities to ensure consideration of nonclinical factors contributing to pregnancy-related deaths—(all to the extent practicable) and redesignating two existing subclauses. (As background, these committees, established under Section 317K of the Public Health Service Act, analyze pregnancy-associated deaths and morbidity to inform prevention efforts.)

This section directs the Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services and the Director of the Agency for Healthcare Research and Quality, to consult with a diverse group of maternal health stakeholders—including pregnant and postpartum individuals (particularly from racial and ethnic minority groups), community-based organizations, maternity care providers, and state maternal mortality review committees—to review existing maternal health data collection processes and quality measures and to make recommendations for improvements. The review must assess specified topics, including (1) state and Tribal practices for maternal health, maternal mortality, and severe maternal morbidity data collection and dissemination (e.g., timeliness of death certificate amendments, electronic health record data on demographics, barriers to correlating outcomes with race and ethnicity, maternal mortality review committee composition and processes, and funding support); (2) the adequacy of such funding; and (3) maternity care quality measures (e.g., prenatal, labor and delivery, and postpartum measures used by hospitals and health plans, international comparisons, and implementation barriers).

This section directs the Secretary of Health and Human Services, in coordination with 12 entities representing each of the 12 Indian Health Service (IHS) service areas and selected from nominees by Indian Tribes, Tribal organizations, and Urban Indian organizations, to enter into a contract not later than 90 days after enactment with an independent research organization or Tribal Epidemiology Center to conduct a comprehensive study on maternal mortality, severe maternal morbidity, and other adverse perinatal or childbirth outcomes among American Indian and Alaska Native individuals. The study must (1) examine unique causes; (2) incorporate stories from affected individuals; (3) distinguish causes, care landscapes, and recommendations across IHS facilities, tribally operated IHS programs, urban Indian health programs, and non-IHS facilities; (4) review coordination with other HHS programs, Medicaid, and CHIP; (5) assess data collection and quality measurement; (6) evaluate maternal mental health conditions and substance use disorders; (7) consider social determinants of health and historical mistreatment; (8) analyze IHS funding impacts and cultural appropriateness of care; (9) recommend reducing misclassification of American Indian and Alaska Native individuals; and (10) provide recommendations informed by individual stories. This section further requires the contractor to submit a report to Congress not later than 36 months after enactment and authorizes $2 million for each of FY2027 through FY2029.

This section establishes a grant program under the Secretary of Health and Human Services to award funds to research centers, health professions schools and programs, and other entities at minority-serving institutions (MSIs, as defined in section 371(a) of the Higher Education Act of 1965 (i.e., historically Black colleges and universities, Hispanic-serving institutions, Tribal Colleges or Universities, Alaska Native-serving and Native Hawaiian-serving institutions, Predominantly Black Institutions, Asian American and Native American Pacific Islander-serving institutions, and Native American-serving nontribal institutions)) for research on maternal mortality, severe maternal morbidity, and other adverse maternal health outcomes among pregnant and postpartum individuals from racial and ethnic minority groups. Grants may support (1) systematic listening processes to understand community-specific causes and solutions; (2) assessment of low Hispanic maternal mortality rates, including potential data misclassification; (3) analysis of adverse outcome disparities among Hispanic subgroups (e.g., prenatal care access); and (4) lactation education to increase racial and ethnic diversity among breastfeeding and lactation experts. The Secretary may use up to 10% of funds for outreach, technical assistance, and capacity building at MSIs; grantees must submit periodic reports; and the Secretary must submit annual reports to Congress on research findings beginning one year after the first grant is awarded. This section authorizes $10 million for each of FY2027 through FY2031.

This section establishes a Maternal Mental Health Equity Grant Program, administered by the Secretary of Health and Human Services (HHS) acting through the Assistant Secretary for Mental Health and Substance Use, to award grants to eligible entities (i.e., community-based organizations serving pregnant and postpartum individuals, particularly those from demographic groups with elevated maternal mortality, severe maternal morbidity, maternal health disparities, or adverse perinatal or childbirth outcomes) for addressing maternal mental health conditions and substance use disorders. In awarding grants, HHS must prioritize applicants that partner with community-based organizations, operate in high-risk areas, or serve health professional shortage areas. Grant funds support 12 specified activities, including (1) integrating maternal mental health care into primary maternity settings; (2) expanding group prenatal or postpartum care; (3) enhancing programs for at-risk demographics; (4) providing services, referrals, and addiction treatment; (5) reducing stigma; (6) raising awareness of warning signs; (7) preventing suicide or self-harm; (8) supporting freestanding birth centers; (9) training maternity providers on identification and referrals; (10) developing provider directories; (11) improving provider coordination via hotlines or similar; and (12) other evidence-based efforts. Grantees must submit annual public reports with evaluations, and HHS must report to Congress by the end of FY2030 on program effectiveness and recommendations for expansion and continuation.

This section authorizes the Secretary of Health and Human Services to award grants to eligible entities to establish or expand educational programs training mental or behavioral health care providers (i.e., those specializing in maternal mental health conditions or substance use disorders), including through scholarships to increase enrollment. In awarding grants (up to five years), the Secretary must prioritize entities with strategies to recruit and retain diverse students (particularly racial and ethnic minorities and other underserved populations), students committing to practice in health professional shortage areas or areas with maternal health disparities, and programs incorporating bias, racism, and implicit bias training in the standard curriculum. Grant recipients must submit annual reports to the Secretary on student demographics, post-graduation practice locations, and training effectiveness; the Secretary must provide technical assistance and submit a report to Congress four years after enactment evaluating the program's impact on workforce diversity and distribution; and the section authorizes $15 million annually for FY2027 through FY2031.

This section decreases by 25% the Edward Byrne Memorial Justice Grant Program allocation to states lacking statewide laws for the fiscal year that are substantially similar to 18 U.S.C. §4322—which prohibits restraining pregnant prisoners in federal custody from pregnancy confirmation through postpartum recovery, subject to limited exceptions for flight risk, threat of harm, or medical necessity—beginning 6 months after enactment and annually thereafter. Amounts withheld from noncompliant states are reallocated to compliant states under the program's formula.

This section directs the Director of the Bureau of Prisons, in consultation with specified stakeholders (e.g., community-based organizations representing incarcerated individuals and high-risk maternal health demographics, patient representatives, maternity care providers, perinatal health workers, and maternal health experts), to establish model programs in at least six Bureau of Prisons facilities within one year of enactment to optimize maternal health outcomes for pregnant and postpartum incarcerated individuals, with facilities required to begin implementation not later than 18 months after enactment and programs operating for a five-year period. In selecting facilities, the Director must prioritize those with higher numbers of pregnant and postpartum individuals—particularly from demographic groups with elevated maternal mortality, severe morbidity, or adverse perinatal outcomes—and demonstrated leadership commitment to such programs. Selected facilities' programs may include (1) access to perinatal health workers; (2) healthy foods, nutrition counseling, activity guidance, and safety measures; (3) training for correctional officers on safe, respectful treatment; (4) training for medical personnel on trauma-informed, culturally congruent care; (5) counseling and treatment for mental/behavioral health conditions, trauma, substance use disorders, HIV, abuse, pregnancy loss, or chronic conditions; (6) evidence-based pregnancy, childbirth, parenting education, and health literacy; (7) clinical training for maternity care providers; (8) newborn bonding opportunities (e.g., enhanced visitation, prison nurseries, breastfeeding support); (9) reentry assistance including health insurance, record transfers, and community referrals addressing social determinants of health; and (10) partnerships with public entities, community organizations, Indian Tribes, Tribal organizations, and Urban Indian organizations to expand pretrial diversion programs offering services such as childbirth education, prenatal coordination, counseling, mental/behavioral health treatments, case management, and supports for social determinants of health. Selected facilities must implement the programs and report results to the Director at three and six years after enactment, including quantitative indicators of improved care standards and health outcomes for pregnant and postpartum individuals.

This section establishes a grant program, to be awarded by the Attorney General through the Director of the Bureau of Justice Assistance not later than one year after enactment, under which States receive Justice for Incarcerated Moms grants to establish or expand programs in State and local prisons and jails for pregnant and postpartum incarcerated individuals. Grants are awarded in consultation with specified stakeholders (e.g., community-based organizations representing incarcerated individuals and high-risk demographic groups, maternity care providers, perinatal health workers, and maternal health researchers); prioritize States based on the number of pregnant and postpartum incarcerated individuals (particularly from demographic groups with elevated maternal mortality, severe maternal morbidity, or related disparities) and demonstrated commitment to exemplary programs; last for five years; and require grantees to report program results to the Attorney General at three and six years after enactment. Grant funds may be used to (1) provide perinatal health workers, healthy foods, nutrition counseling, and safety measures; (2) train correctional officers and medical personnel for respectful, trauma-informed care; (3) offer counseling and treatment for mental/behavioral health conditions, trauma, substance use disorders, HIV, abuse, pregnancy loss, or chronic conditions; (4) deliver evidence-based pregnancy/childbirth education, parenting support, and health literacy; (5) provide clinical training for maternity care providers and bonding opportunities (e.g., enhanced visitation, prison nurseries, breastfeeding support); (6) furnish reentry assistance including health insurance access, record transfers, and community referrals; or (7) partner with public entities, community organizations, Indian Tribes, Tribal organizations, and Urban Indian organizations to establish or expand pretrial diversion programs featuring education, counseling, case management, and services addressing social determinants of health.

This section directs the Comptroller General of the United States to submit to Congress, not later than two years after the date of enactment of this Act, a report on adverse maternal and infant health outcomes among incarcerated individuals—including those in federal, state, and local facilities—and infants born to such individuals, with a particular focus on racial and ethnic disparities. The report must include, to the extent practicable and covering the most recent 10 years of available data: (1) the number of pregnant individuals incarcerated in Bureau of Prisons facilities; (2) the number of incarcerated individuals who have experienced pregnancy-related or pregnancy-associated deaths or infant deaths; (3) the number of cases of severe maternal morbidity among incarcerated individuals; (4) the number of preterm and low-birthweight births to incarcerated individuals; and (5) statistics on racial and ethnic disparities in such outcomes. If data in (1)-(3) are unavailable, the report must assess barriers to obtaining it and recommend improvements in tracking; it must also cover implications of pregnant and postpartum incarcerated individuals' ineligibility for Medicaid, effects of detention policies for those testing positive for illicit drugs, causes of adverse outcomes unique to incarcerated individuals (including racial and ethnic minorities), recommendations to reduce maternal mortality and morbidity and address disparities, and other relevant information.

This section adds to the list of payment and service delivery models to be tested by the Center for Medicare and Medicaid Innovation (CMI) a new model focused on Medicaid (Title XIX), providing for the adoption and use of telehealth tools to screen, monitor, and manage common health complications for pregnant individuals and during the one-year postpartum period. (As background, the CMI tests such models to reduce Medicare and Medicaid expenditures while preserving or enhancing care quality.) The amendment takes effect one year after enactment.

This section establishes a grant program under which the Secretary of Health and Human Services (HHS), beginning not later than 1 year after enactment, awards a single 5-year grant to an eligible entity (i.e., an entity that provides or supports maternal health care services) to evaluate, develop, and expand technology-enabled collaborative learning and capacity building models (i.e., virtual platforms for provider training and best-practice sharing) to improve maternal health outcomes in health professional shortage areas, areas with high rates of maternal mortality or severe morbidity, rural and underserved areas, areas with significant maternal health disparities, and for medically underserved populations including American Indians and Alaska Natives. Grant recipients must use funds to train maternal health care providers on specified topics (e.g., safety/quality improvement, implicit bias, maternal mental health and substance use screening/treatment, public health emergency maternity care, social determinants of health screening, remote patient monitoring for pregnancy complications); evaluate model effects on care access/quality, patient outcomes, and experiences; develop best-practice measures; study provider impacts; and conduct related activities, and may use funds for enabling technologies (e.g., distance learning hardware/software, secure health information exchange) and provider support. HHS must provide technical assistance on model development/use/sustainability; develop a research/evaluation strategic plan; coordinate broadband access; and submit a report to Congress 4 years after enactment describing grants, evaluations, assistance, activities, outcomes, and best practices, with grantees also reporting to HHS. This section authorizes $6 million annually for FY2027 through FY2031.

This section directs the Secretary of Health and Human Services (HHS), beginning one year after enactment, to award a single five-year grant to an eligible entity to reduce maternal health disparities by increasing access to digital tools related to maternal health care, including provider-facing technologies such as early warning systems and clinical decision support mechanisms. In prioritizing grant applicants, HHS must give preference to entities (1) in areas with elevated rates of maternal mortality, severe maternal morbidity, maternal health disparities, or adverse perinatal or childbirth outcomes; (2) in a health professional shortage area, rural area, or underserved area; and (3) that promote technology addressing maternal health disparities. The section further requires HHS to provide technical assistance to grantees on digital tool development, use, evaluation, and sustainability; mandates reporting by grantees to HHS and, four years after enactment, a report to Congress evaluating grant effectiveness (particularly for racial and ethnic minorities), with recommendations on new technology grant programs and topics including maternal telehealth reimbursement, privacy safeguards, data sharing barriers, and lessons from COVID-19 telehealth expansions; and authorizes $6 million annually for FY2027 through FY2031.

This section directs the Secretary of Health and Human Services, not later than 60 days after enactment, to seek an agreement with the National Academies of Sciences, Engineering, and Medicine to conduct a study on the use of technology and patient monitoring devices in maternity care. The study must address (1) the use of innovative technology, including artificial intelligence, and its effects on racial or ethnic biases in maternal health care; (2) the use of patient monitoring devices, including pulse oximeters, and their effects on such biases; (3) best practices for reducing and preventing biases; (4) best practices for use among pregnant and postpartum individuals from racial and ethnic minority groups; and (5) best practices for privacy and security safeguards. The National Academies must complete the study and transmit a report to Congress not later than 24 months after enactment.

This section establishes the Perinatal Care Alternative Payment Model Demonstration Project for FY2027 through 2031, under which states may test alternative payment models (as defined in SSA §1833(z)(3)(C)) for maternity care provided to pregnant and postpartum individuals (i.e., perinatal period from pregnancy onset through one year postpartum) under Medicaid and CHIP state plans. In implementing the project, the Secretary of Health and Human Services, acting through the CMS Administrator, must coordinate with specified stakeholders (e.g., state Medicaid programs, maternity care providers, patient representatives from high-risk demographic groups, community-based organizations, and researchers); consider models that address maternal health disparities through risk stratification, evidence-based quality metrics, nonhospital birth settings, social determinants of health, diverse maternity care teams, and maternal mental health or substance use disorders; and approve participating states via application. The Secretary must evaluate the project's impacts on maternal health outcomes (stratified by race, ethnicity, etc.), maternity care spending, patient experience, and other relevant areas; and submit a report to Congress within one year after completion or termination containing evaluation results and recommendations on continuation and national expansion. This section authorizes appropriations of such sums as necessary.

This section defines, for purposes of this title, (1) "respectful maternity care" as care for pregnant and postpartum individuals that is culturally and linguistically congruent, maintains their dignity, privacy, and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support; and (2) "Secretary" as the Secretary of Health and Human Services.

This section authorizes appropriations to support CDC and NICHD data collection, surveillance, and research on maternal health outcomes during public health emergencies and infectious diseases posing risks to maternal and infant health, with emphases on racial/ethnic minorities and other high-risk demographic groups. The amounts authorized are (1) $100 million for the CDC's Surveillance for Emerging Threats to Mothers and Babies program to provide guidance, expand data partnerships, and establish regional centers of excellence; (2) $30 million for the CDC's Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) program to expand state and tribal partnerships and provide technical assistance to Maternal Mortality Review Committees; (3) $45 million for the CDC's Pregnancy Risk Assessment Monitoring System (PRAMS) to add emergency-related supplements and respectful maternity care questions, transition to an electronic platform, and expand to underrepresented communities; and (4) $15 million for the National Institute of Child Health and Human Development to conduct or support intervention research.

This section directs the Secretary of Health and Human Services (HHS), acting through the Centers for Disease Control and Prevention (CDC) director and Centers for Medicare & Medicaid Services (CMS) administrator, to make publicly available on the CDC website data collected through CDC federal surveillance systems on pregnant and postpartum individuals during public health emergencies declared under section 319 of the Public Health Service Act. Such data includes (1) diagnostic testing, confirmed cases, hospitalizations, deaths, and other health outcomes related to infectious disease outbreaks among pregnant and postpartum individuals; and (2) maternal and infant health outcomes among individuals who test positive for an infectious disease during or after pregnancy. The section further requires the Secretary to (1) disaggregate such data by race, ethnicity, gender, primary language, geography, socioeconomic status, and other relevant factors; (2) update the data at least monthly during a public health emergency and not less than once within one month after the emergency ends; (3) protect privacy consistent with HIPAA regulations (i.e., all data deidentified with no disclosure of individually identifying or potentially identifying information and collected consistent with federal and state privacy laws); (4) consult with Indian Tribes and confer with Urban Indian organizations, including to incorporate tribally developed best practices and reduce misclassification of American Indians and Alaska Natives; and (5) issue guidance to states and local public health departments within 30 days of a public health emergency declaration to ensure laboratories receive relevant demographic data (including on race, ethnicity, and pregnancy status) and data are disaggregated as specified.

This section directs the Director of the Centers for Disease Control and Prevention (CDC) to conduct public health education campaigns during public health emergencies. The campaigns must provide accurate, evidence-based information on maternal and infant health risks to pregnant and postpartum individuals, their employers, and health care providers, with a particular focus on reaching pregnant and postpartum individuals in underserved communities.

This section establishes a Task Force, convened by the HHS Secretary in consultation with the CDC Director and HRSA Administrator, to develop, publicly post, and update Federal recommendations in multiple languages on respectful, responsive, and empowering maternity care—including safe birth and postpartum care—during public health emergencies. The recommendations must ensure high-quality, nondiscriminatory care and improved maternal health outcomes, with a focus on demographic groups facing elevated maternal mortality, morbidity, or disparities, and address 21 specified topics such as equitable treatment by race and ethnicity; telehealth and high-risk pregnancy care; birthing with companions (including via telehealth); newborn separation and breastfeeding amid maternal infection; midwifery licensure, training, and reimbursement; doula Medicaid coverage; mental and behavioral health conditions; intimate partner violence; hospital capacity and birth centers; childcare during appointments; bias training and data collection; needs of undocumented, uninsured, or underinsured individuals; maternal mood and substance use disorders; and infant nutrition. The Task Force must also (1) identify implementation barriers, (2) consider effective existing State and other programs, and (3) specify emergency policies to discontinue or continue post-emergency. Task Force membership, appointed by the Secretary, includes representatives from specified HHS agencies (e.g., CDC, HRSA, CMS, AHRQ, FDA, Assistant Secretary for Mental Health and Substance Use, and Indian Health Service) and at least three State, local, or territorial public health officials.

This section establishes definitions for terms used in this title, including (1) adverse maternal and infant health outcomes (i.e., preterm birth, low birth weight, stillbirth, infant or maternal mortality, and severe maternal morbidity); (2) institution of higher education (as defined in section 101 of the Higher Education Act of 1965); (3) minority-serving institution (i.e., entities specified in section 371(a) of the Higher Education Act of 1965, such as historically Black colleges and universities and Hispanic-serving institutions); (4) risks associated with climate change (i.e., extreme heat, air pollution, extreme weather events, and other environmental issues that can result in adverse maternal and infant health outcomes); (5) Secretary (i.e., Secretary of Health and Human Services); (6) stakeholder organization (i.e., certain community-based, nonprofit, or patient advocacy organizations); and (7) vulnerable individual (i.e., pregnant individuals, individuals pregnant within the preceding year, and individuals under 3 years of age).

This section establishes a grant program, to be set up by the Secretary of Health and Human Services not later than 180 days after enactment, under which the Secretary may competitively award grants to 10 covered entities to protect vulnerable individuals (i.e., pregnant individuals, infants, and young children) from climate change risks, with grant recipients to be selected not later than 270 days after enactment. In selecting recipients, the Secretary must consult representatives of stakeholder organizations; the EPA and NOAA Administrators; and specified HHS officials (Deputy Assistant Secretary for Minority Health, CMS and HRSA Administrators, NIH Director, and CDC Director), giving priority to entities serving areas with high social vulnerability; air quality nonattainment; extreme heat risks; elevated maternal mortality or morbidity; high natural hazard risk; or other climate-sensitive hazards linked to adverse maternal or infant outcomes. (Recipients may not use funds to serve counties or localities served by other recipients.) Grant funds may be used only for (1) initiatives to identify climate risks for vulnerable individuals and provide related services and support, including provider training; perinatal health worker hiring and resources; risk monitoring and data sharing; and distribution of air conditioning units, weatherization, financial assistance, housing/evacuation/transportation support, cooling shelter access, or mental health counseling; and (2) initiatives to mitigate exposure to such risks. Applications must describe plans developed with patient and stakeholder input; targeting of high-risk areas; addressing racial/ethnic disparities in maternal/infant outcomes and climate exposure; and strategies to avoid adverse environmental, displacement, housing cost, or disproportionate impacts.

This section establishes a grant program, to be administered by the Secretary of Health and Human Services not later than one year after enactment, to award competitive grants to health profession schools (i.e., accredited medical schools, schools of nursing, midwifery programs, physician assistant education programs, teaching hospitals, residency or fellowship programs, or other programs deemed appropriate by the Secretary) for developing and integrating curriculum and continuing education on identifying and addressing climate change risks for vulnerable individuals and individuals intending to become pregnant. Grant applications must describe engagement with vulnerable individuals and stakeholder organizations and efforts to address racial and ethnic disparities in such risks and effects; funds support training on specified topics including risk identification and effects, disparities, patient counseling and mitigation strategies, relevant services and access thereto, implicit and explicit bias and discrimination, and related topics identified through stakeholder engagement. Grantees may partner with state or local public health departments, health care professional organizations, stakeholder organizations, health profession schools, or institutions of higher education and must submit annual and final reports to the Secretary, who must submit a summary report with recommendations to Congress six years after program establishment. Authorizes $5 million for FY2027 through 2030.

This section establishes within the National Institutes of Health (NIH), not later than one year after enactment, the Consortium on Birth and Climate Change Research to coordinate research across NIH institutes, centers, and offices on climate change risks to vulnerable individuals, with a focus on disparities among racial and ethnic minority groups and other underserved populations. The consortium must (1) establish research priorities and strategies to reduce such risks; (2) identify gaps in data and research collaborations; (3) identify funding opportunities for community-based organizations and diverse researchers; (4) identify public awareness opportunities; and (5) publish annual reports on its website. Membership includes representatives from at least the National Institute of Environmental Health Sciences, National Institute on Minority Health and Health Disparities, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Mental Health, National Institute of Nursing Research, and Office of Research on Women's Health; the NIH director designates the chairperson and directs consultation with specified federal agencies (e.g., EPA, NOAA), HHS offices (e.g., CDC, IHS), and stakeholders (e.g., maternal health providers, minority-serving institutions).

This section directs the Secretary of Health and Human Services (HHS), acting through the Director of the Centers for Disease Control and Prevention (CDC), to develop a strategy for designating areas at high risk of adverse maternal and infant health outcomes among vulnerable individuals due to climate change risks, in conjunction with factors such as air pollution-related diseases, extreme heat, access to maternal and infant health care, English-language proficiency and health insurance status among women of reproductive age, racial or ethnic disparities in health outcomes, socioeconomic status (including poverty, unemployment, household income, and educational attainment), and access to quality housing, transportation, and nutrition. In developing the strategy, the Secretary must identify and describe (1) existing mapping tools, federal programs, environmental/health/socioeconomic/demographic data, and monitoring networks relevant to such risks (including gaps and needed enhancements at subcounty and census tract levels); (2) relevant federal, state, and local stakeholders and their coordination; (3) funding required for new or enhanced monitoring networks; and (4) potential data uses, including for grants under section 1202 or similar programs. The Secretary must coordinate with the EPA and NOAA Administrators; consult stakeholders such as health care providers, state and local public health departments, hospitals and birth centers serving vulnerable individuals, and institutions of higher education (including minority-serving institutions); provide notice on an HHS website and at least 90 days for public comment at least 240 days before publication; and publish the strategy, comments received, and agency responses on an HHS website not later than 18 months after enactment.

This section establishes the IMPROVE Initiative (Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone Initiative) within the National Institutes of Health (NIH) to advance research on reducing preventable maternal mortality and severe maternal morbidity, addressing related health disparities (including for disproportionately affected populations), and improving health for pregnant and postpartum women through integrated, region-specific, and community-based approaches. The Director of NIH may award grants, contracts, or cooperative agreements to implement the Initiative, which authorizes $73,400,000 for each of fiscal years 2027 through 2032.

This section revises the national vaccine awareness campaign to (1) expand its vaccination rate goals to include pregnant and postpartum individuals, (2) add obstetric care providers and facilities to vaccine information dissemination targets (in addition to prenatal and pediatric), and (3) include information on vaccinations for pregnant and postpartum individuals; increases annual funding for the campaign to $17 million for FY2027 through FY2031 (from $15 million for FY2021 through FY2025); and adds a new purpose to CDC immunization grants—namely, increasing vaccination rates among pregnant and postpartum individuals, including from racial and ethnic minority groups, and their children. (The campaign, administered by CDC, combats vaccine misinformation and promotes vaccination, especially in low-vaccination communities.)