H.R. 8074 — Kira Johnson Act

This section establishes a grant program administered by the Secretary of Health and Human Services (HHS) for 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. (As background, maternal health disparities disproportionately affect certain racial and ethnic minorities, rural populations, and low-income groups, contributing to the U.S. having one of the highest maternal mortality rates among developed nations.) The Secretary must conduct a one-year outreach and technical assistance (TA) period beginning on the date of enactment prior to commencing grant awards and must give special consideration in both outreach and awards to organizations based in or led by affected communities that provide specified services (e.g., maternal mental health and substance use disorder support, social determinants of health interventions, perinatal health worker support, midwifery expansion, and pregnancy loss assistance). The Secretary must also provide TA to grant recipients on capacity building, data practices, and program sustainability and submit to Congress by the end of FY2031 an evaluation assessing the program's effectiveness in diversifying recipients and improving maternal health outcomes, with recommendations for future HHS maternal health grants.

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. In awarding grants, the HHS Secretary must give special consideration to programs that (1) cover all maternity care providers and interacting employees (e.g., front desk staff, sonographers, security); (2) provide periodic trainings addressing implicit bias, racism, cultural humility, trauma-informed care, shared decision making, and antiracism; (3) are delivered via continuing education (with preference for continuing education units), undergraduate health professions pipelines, WIC providers, obstetric simulations, emergency department/EMT training, or programs from HBCUs or other minority-serving institutions; and (4) train on diverse maternity care teams. Grantees must submit annual reports on activities and impacts on patient outcomes and experiences for racial and ethnic minority groups; the Secretary must issue and disseminate annual reports on findings, including best practices. Authorizes $5 million for FY2027 through FY2031.

This section directs the Secretary of Health and Human Services to seek to enter into an agreement within 90 days of enactment with the National Academies of Sciences, Engineering, and Medicine to 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. The National Academies must complete the study and transmit a report to Congress within 24 months of enactment, potentially covering topics such as (1) developing scorecards or evaluation standards to assess program effectiveness for racial and ethnic minority pregnant and postpartum individuals and their families, and (2) determining effective types and frequency of related training.

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 implementation initiatives. Funded programs must (1) institutionalize reporting mechanisms for patients, families, or perinatal health workers to report racism or bias based on race, ethnicity, or another protected class; (2) provide timely follow-up responses to reporters; (3) develop and publicly release a strategy to reduce such bias, including employee training programs, reported case numbers, and routine assessments in maternity care delivery; (4) routinely collect and publicly report hospital-level patient experience data; and (5) submit annual reports to the Secretary on reported cases, including deidentified patient demographics, report content, program responses, and resulting institutional changes. Within 180 days of enactment, the Secretary must establish processes to disseminate best practices for such programs, promote coordination among maternity care settings, and evaluate program effectiveness on maternal health outcomes and patient experiences, especially for racial and ethnic minority groups. Within two years of enactment, the Secretary must contract with an independent research organization to study strategies addressing racism or bias in maternity care, assess submitted program reports, and recommend accountability mechanisms, with results reported to Congress and made publicly available. Authorizes appropriations for FY2027 through 2032.

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 within hospitals, health systems, and other maternity care settings—not later than two years after the date of enactment and annually thereafter. The report must include (1) the extent to which such programs have been established (including which settings, establishment timelines, impacts on maternal health outcomes and patient/family experiences—especially for racial and ethnic minorities—areas and settings without programs and contributing factors, and recommendations for broader establishment); (2) whether funding for this section is sufficient, with recommendations for additional appropriations if applicable; and (3) other information as the Comptroller General determines appropriate.

This section establishes definitions for nine terms used in the Act, including (1) culturally and linguistically congruent (i.e., care in agreement with the health care consumer's cultural values, beliefs, worldview, language, and practices); (2) maternal mortality (i.e., death during or within one year after pregnancy from pregnancy-related or childbirth complications, including suicide, overdose, or mental health or substance use disorders attributed to or aggravated by such complications); (3) perinatal health worker (i.e., nonclinical worker focused on maternal or perinatal health, such as a doula, community health worker, or lactation counselor); (4) postpartum (i.e., one-year period beginning on the last day of pregnancy); (5) pregnancy-associated death (i.e., any death of a pregnant or postpartum individual during or within one year after pregnancy); (6) pregnancy-related death (i.e., death during or within one year after pregnancy from a pregnancy complication, chain of events initiated by pregnancy, or aggravation of an unrelated condition by pregnancy); (7) racial and ethnic minority group; (8) severe maternal morbidity (i.e., health condition attributed to or aggravated by pregnancy or childbirth with significant short- or long-term consequences); and (9) social determinants of maternal health (i.e., nonclinical factors impacting maternal health outcomes).