S. 4195 — Kira Johnson Act

This section directs the Secretary of Health and Human Services to award 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, commencing after a one-year outreach and technical assistance period beginning on the date of enactment. In conducting outreach and awarding grants, the Secretary must give special consideration 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, group prenatal or postpartum care, midwifery expansion, pregnancy loss support, and infant formula mutual aid). The Secretary must provide technical assistance 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 maternal health grants.

This section establishes a grant program under the Public Health Service Act to reduce and prevent bias, racism, and discrimination in maternity care settings and to advance respectful, culturally and linguistically congruent, trauma-informed care. In awarding grants, the Secretary must give special consideration to programs that (1) apply to all maternity care providers and interacting employees (e.g., front desk staff, sonographers, administrators, security); (2) emphasize periodic trainings addressing implicit bias, racism, cultural humility, antiracism, trauma-informed care, and shared decision making; (3) are delivered in continuing education (preferring continuing education units), undergraduate health professions pipelines, WIC provider settings, or obstetric emergency simulations; (4) train emergency personnel on severe pregnancy complications; (5) promote diverse maternity care teams; or (6) are designed by historically Black colleges or universities or other minority-serving institutions. Grant recipients must report annually on activities and impacts on patient outcomes and experiences for racial and ethnic minorities; the Secretary must issue and disseminate annual reports on findings and best practices. The section authorizes $5 million annually for FY2027 through FY2031.

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

This section directs the Secretary of Health and Human Services to award grants to accredited hospitals, health systems, and maternity care settings to establish respectful maternity care compliance programs that institutionalize (1) mechanisms for patients, families, or perinatal health workers to report racism or bias based on race, ethnicity, or another protected class; (2) timely response mechanisms; (3) a publicly available strategy to reduce such bias, including training, reported cases, and assessment methods; (4) routine collection and public reporting of patient experience data; and (5) annual reports to the Secretary with deidentified case details. Not later than 180 days after enactment, the Secretary must establish processes to disseminate best practices, promote coordination among settings, and evaluate program effectiveness on maternal health outcomes, particularly for racial and ethnic minorities. Not later than two years after enactment, the Secretary must contract with an independent research organization for a study assessing reported cases and recommending accountability mechanisms for bias in maternity care, with results reported to Congress; the section authorizes appropriations 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 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) information on the extent of program establishment, which hospitals and birth settings elect to establish such programs and when, impacts on maternal health outcomes and patient experiences (especially for racial and ethnic minority groups), geographic and facility-type gaps in program establishment and contributing factors, and recommendations to address such gaps; (2) an assessment of whether funding for this section is sufficient, with recommendations for additional appropriations if applicable; and (3) other information as the Comptroller General determines appropriate.