Bill Summary
This legislation, titled the "Tech to Save Moms Act," aims to improve maternal health outcomes, especially for underserved populations, through investments in technology. It amends the Social Security Act to focus on the adoption and use of telehealth tools for screening and treating common pregnancy-related complications. It also establishes a grant program under the Public Health Service Act for expanding the use of technology-enabled collaborative learning and capacity building models in underserved areas. Additionally, the legislation defines key terms, such as maternal mortality and severe maternal morbidity, and authorizes a program to promote equity in maternal health outcomes by increasing access to digital tools. The Secretary of Health and Human Services is required to report on the impact and effectiveness of these grants and make recommendations for future programs.
Possible Impacts
1. Underserved populations will benefit from increased access to technology-enabled collaborative learning and capacity building models for maternal health care through the grant program established in Section 3 of the bill.
2. Pregnant women in underserved areas will have better access to telehealth tools for screening and treating common pregnancy-related complications, thanks to the amendment of the Social Security Act in Section 2 of the legislation.
3. The Tech to Save Moms Act will prioritize reducing racial and ethnic disparities in maternal health outcomes, as seen in the establishment of a program to promote equity through increased access to digital tools and the requirement for the Secretary to report on the effectiveness of these programs in Section 3 of the bill.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6138 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 6138
To improve maternal health outcomes, especially for underserved
populations, through investments in technology, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 9, 2020
Ms. Johnson of Texas (for herself, Ms. Underwood, Ms. Adams, Ms. Sewell
of Alabama, Ms. Norton, Ms. Scanlon, Ms. Moore, 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 improve maternal health outcomes, especially for underserved
populations, through investments in technology, 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 ``Tech to Save Moms Act''.
SEC. 2. CMI MODELING OF INTEGRATED TELEHEALTH MODELS IN MATERNITY CARE
SERVICES.
(a) In General.--Section 1115A(b)(2)(B) of the Social Security Act
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the end the
following new clauses:
``(xxviii) Focusing on title XIX, providing
for the adoption of and use of telehealth tools
that allow for screening and treatment of
common pregnancy-related complications
(including anxiety and depression, substance
use disorder, hemorrhage, infection, amniotic
fluid embolism, thrombotic pulmonary or other
embolism, hypertensive disorders of pregnancy,
cerebrovascular accidents, cardiomyopathy, and
other cardiovascular conditions) for a pregnant
woman receiving medical assistance under such
title during her pregnancy and for not more
than a 1-year period beginning on the last day
of her pregnancy.''.
(b) Effective Date.--The amendment made by subsection (a) shall
take effect 1 year after the date of the enactment of this Act.
SEC. 3. GRANTS TO EXPAND THE USE OF TECHNOLOGY-ENABLED COLLABORATIVE
LEARNING AND CAPACITY MODELS THAT PROVIDE CARE TO
PREGNANT AND POSTPARTUM WOMEN.
Title III of the Public Health Service Act is amended by inserting
after section 330M (42 U.S.C. 254c-19) the following:
``SEC. 330N. EXPANDING CAPACITY FOR MATERNAL HEALTH OUTCOMES.
``(a) Program Established.--Beginning not later than 1 year after
the date of enactment of this Act, the Secretary of Health and Human
Services shall, as appropriate, award grants to eligible entities to
evaluate, develop, and, as appropriate, expand the use of technology-
enabled collaborative learning and capacity building models, to improve
maternal health outcomes in health professional shortage areas; areas
with high rates of maternal mortality and severe maternal morbidity,
and significant racial and ethnic disparities in maternal health
outcomes; and for medically underserved populations or American Indians
and Alaska Natives, including Indian tribes, Tribal organizations, and
urban Indian organizations.
``(b) Use of Funds.--
``(1) Required uses.--Grants awarded under subsection (a)
shall be used for--
``(A) the development and acquisition of
instructional programming, and the training of maternal
health care providers and other professionals that
provide or assist in the provision of services through
models such as--
``(i) training on adopting and effectively
implementing Alliance for Innovation on
Maternal Health (referred to in this section as
`AIM') safety and quality improvement bundles;
``(ii) training on implicit and explicit
bias, racism, and discrimination for providers
of maternity care;
``(iii) training on best practices in
screening for and, as needed, evaluating and
treating maternal mental health conditions and
substance use disorders;
``(iv) training on how to screen for social
determinants of health risks in the prenatal
and postpartum periods such as inadequate
housing, lack of access to nutrition,
environmental risks, and transportation
barriers; and
``(v) training on the use of remote patient
monitoring tools for pregnancy-related
complications described in section
1115A(b)(2)(B)(xxviii);
``(B) information collection and evaluation
activities to--
``(i) study the impact of such models on--
``(I) access to and quality of
care;
``(II) patient outcomes;
``(III) subjective measures of
patient experience; and
``(IV) cost-effectiveness; and
``(ii) identify best practices for the
expansion and use of such models;
``(C) information collection and evaluation
activities to study the impact of such models on
patient outcomes and maternal health care providers,
and to identify best practices the expansion and use of
such models; and
``(D) any other activity consistent with achieving
the objectives of grants awarded under this section, as
determined by the Secretary.
``(2) Permissible uses.--In addition to any of the uses
under paragraph (1), grants awarded under subsection (a) may be
used for--
``(A) equipment to support the use and expansion of
technology-enabled collaborative learning and capacity
building models, including for hardware and software
that enables distance learning, maternal health care
provider support, and the secure exchange of electronic
health information; and
``(B) support for maternal health care providers
and other professionals that provide or assist in the
provision of maternity care services through such
models.
``(c) Limitations.--
``(1) Number.--The Secretary may not award more than 1
grant under this section to an eligible entity.
``(2) Duration.--Each grant under this section shall be
made for a period of up to 5 years.
``(3) Amount.--The Secretary shall determine the maximum
amount of each grant under this section.
``(d) Grant Requirements.--The Secretary shall require entities
awarded a grant under this section to collect information on the effect
of the use of technology-enabled collaborative learning and capacity
building models, such as on maternal health outcomes, access to
maternal health care services, quality of maternal health care, and
maternal health care provider retention in areas and populations
described in subsection (a). The Secretary may award a grant or
contract to assist in the coordination of such models, including to
assess outcomes associated with the use of such models in grants
awarded under subsection (a), including for the purpose described in
subsection (b)(1)(B).
``(e) Application.--
``(1) In general.--An eligible entity that seeks to receive
a grant under subsection (a) shall submit to the Secretary an
application, at such time, in such manner, and containing such
information as the Secretary may require.
``(2) Matters to be included.--Such application shall
include plans to assess the effect of technology-enabled
collaborative learning and capacity building models on
indicators, including access to and quality of care, patient
outcomes, subjective measures of patient experience, and cost-
effectiveness. Such indicators may focus on--
``(A) health professional shortage areas;
``(B) areas with high rates of maternal mortality
and severe maternal morbidity, and significant racial
and ethnic disparities in maternal health outcomes; and
``(C) medically underserved populations or American
Indians and Alaska Natives, including Indian tribes,
Tribal organizations, and urban Indian organizations.
``(f) Access to Broadband.--In administering grants under this
section, the Secretary may coordinate with other agencies to ensure
that funding opportunities are available to support access to reliable,
high-speed internet for grantees.
``(g) Technical Assistance.--The Secretary shall provide (either
directly through the Department of Health and Human Services or by
contract) technical assistance to eligible entities, including
recipients of grants under subsection (a), on the development, use, and
post-grant sustainability of technology-enabled collaborative learning
and capacity building models in order to expand access to maternal
health care services provided by such entities, including for health
professional shortage areas and areas with high rates of maternal
mortality and severe maternal morbidity, and significant racial and
ethnic disparities in maternal health outcomes, and to medically
underserved populations or American Indians and Alaska Natives,
including Indian tribes, Tribal organizations, and urban Indian
organizations.
``(h) Research and Evaluation.--The Secretary, in consultation with
stakeholders with appropriate expertise in such models, shall develop a
strategic plan to research and evaluate the evidence for such models.
The Secretary shall use such plan to inform the activities carried out
under this section.
``(i) Reporting.--
``(1) By eligible entities.--An eligible entity that
receives a grant under subsection (a) shall submit to the
Secretary a report, at such time, in such manner, and
containing such information as the Secretary may require.
``(2) 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
including, at minimum--
``(A) a description of any new and continuing
grants awarded under subsection (a) and the specific
purpose and amounts of such grants;
``(B) an overview of--
``(i) the evaluations conducted under
subsection (b);
``(ii) technical assistance provided under
subsection (g); and
``(iii) activities conducted by entities
awarded grants under subsection (a); and
``(C) a description of any significant findings
related to patient outcomes or maternal health care
providers and best practices for eligible entities
expanding, using, or evaluating technology-enabled
collaborative learning and capacity building models.
``(j) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $6,000,000 for each of fiscal
years 2021 through 2025.
``(k) Definitions.--In this section:
``(1) Eligible entity.--
``(A) In general.--The term `eligible entity' means
an entity that provides, or supports the provision of,
maternal health care services or other evidence-based
services for pregnant and postpartum women--
``(i) in health professional shortage
areas;
``(ii) in areas with high rates of adverse
maternal health outcomes and significant racial
and ethnic disparities in maternal health
outcomes; or
``(iii) medically underserved populations
or American Indians and Alaska Natives,
including Indian tribes, Tribal organizations,
and urban Indian organizations.
``(B) Inclusions.--An eligible entity may include
entities leading, or capable of leading, a technology-
enabled collaborative learning and capacity building
model or engaging in technology-enabled collaborative
training of participants in such model.
``(2) Health professional shortage area.--The term `health
professional shortage area' means a health professional
shortage area designated under section 332.
``(3) Indian tribe.--The term `Indian tribe' has the
meaning given such term in section 4 of the Indian Self-
Determination and Education Assistance Act.
``(4) Maternal mortality.--The term `maternal mortality'
means a death occurring during or within a 1-year period after
pregnancy caused by pregnancy or childbirth complications.
``(5) Medically underserved population.--The term
`medically underserved population' has the meaning given such
term in section 330(b)(3).
``(6) Postpartum.--The term `postpartum' means the 1-year
period beginning on the last date of the pregnancy of a woman.
``(7) Severe maternal mortality.--The term `severe maternal
morbidity' means an unexpected outcome caused by labor and
delivery of a woman that results in a significant short-term or
long-term consequences to the health of the woman.
``(8) Technology-enabled collaborative learning and
capacity building model.--The term `technology-enabled
collaborative learning and capacity building model' means a
distance health education model that connects health care
professionals, and particularly specialists, with multiple
other health care professionals through simultaneous
interactive videoconferencing for the purpose of facilitating
case-based learning, disseminating best practices, and
evaluating outcomes in the context of maternal health care.
``(9) Tribal organization.--The term `Tribal organization'
has the meaning given such term in section 4 of the Indian
Self-Determination and Education Assistance Act.
``(10) Urban indian organization.--The term `urban Indian
organization' has the meaning given such term in section 4 of
the Indian Health Care Improvement Act.''.
SEC. 4. GRANTS TO PROMOTE EQUITY IN MATERNAL HEALTH OUTCOMES BY
INCREASING ACCESS TO DIGITAL TOOLS.
(a) In General.--Beginning not later than 1 year after the date of
the enactment of this Act, the Secretary of Health and Human Services
shall carry out a program (in this section referred to as ``Investments
in Digital Tools to Promote Equity in Maternal Health Outcomes
Program'' or ``Program'') under which the Secretary makes grants to
eligible entities reduce racial and ethnic disparities in maternal
health outcomes by increasing access to digital tools related to
maternal health care.
(b) Applications.--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 require.
(c) Limitations.--
(1) Number.--The Secretary may not award more than 1 grant
under this section to an eligible entity.
(2) Duration.--Each grant under this section shall be made
for a period of not more than 5 years.
(3) Amount.--The Secretary shall determine the maximum
amount of each grant under this section.
(4) Prioritization.--In awarding grants under this section,
the Secretary shall prioritize the selection of an eligible
entity that--
(A) operates in an area with high rates of adverse
maternal health outcomes and significant racial and
ethnic disparities in maternal health outcomes; and
(B) promotes technology that address racial and
ethnic disparities in maternal health outcomes.
(d) Technical Assistance.--The Secretary shall provide technical
assistance to an eligible entity on the development, use, evaluation,
and post-grant sustainability of digital tools for purposes of
promoting equity in maternal health outcomes.
(e) Reporting.--
(1) By eligible entities.--An eligible entity that receives
a grant under subsection (a) shall submit to the Secretary a
report, at such time, in such manner, and containing such
information as the Secretary may require.
(2) By the secretary.--Not later than 4 years after the
date of the enactment of this Act, the Secretary shall submit
to Congress a report that--
(A) evaluates the effectiveness of grants awarded
under this section in improving maternal health
outcomes for minority women;
(B) makes recommendations for future grant programs
that promote the use of technology to improve maternal
health outcomes for minority women; and
(C) makes recommendations that address--
(i) privacy and security safeguards that
should implemented in the use of technology in
maternal health care;
(ii) reimbursement rates for maternal
telehealth services;
(iii) the use of digital tools to analyze
large data sets for the purposes of identifying
potential pregnancy-related complications as
early as possible;
(iv) barriers that prevent maternal health
care providers from providing telehealth
services across States and recommendations from
the Centers for Medicare and Medicaid Services
for addressing such barriers in State Medicaid
programs;
(v) the use of consumer digital tool such
as mobile phone applications, patient portals,
and wearable technologies to improve maternal
health outcomes;
(vi) barriers that prevent consumers from
accessing telehealth services or other digital
technologies to improve maternal health
outcomes, including a lack of access to
reliable, high-speed internet or lack of access
to electronic devices needed to use such
services and technologies; and
(vii) any other related issues as
determined by the Secretary.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $6,000,000 for each of fiscal
years 2021 through 2025.
(g) Eligible Entity Defined.--In this section, the term ``eligible
entity'' is an entity that is described in section 51a.3(a) of title
42, Code of Federal Regulations, including domestic faith-based and
community-based organizations.
SEC. 5. REPORT ON THE USE OF TECHNOLOGY TO REDUCE MATERNAL MORTALITY
AND SEVERE MATERNAL MORBIDITY AND TO CLOSE RACIAL AND
ETHNIC DISPARITIES IN OUTCOMES.
(a) In General.--Not later than 60 days after the date of enactment
of this Act, the Secretary of Health and Human Services shall seek to
enter an agreement with the National Academies of Sciences,
Engineering, and Medicine (referred to in this Act as the ``National
Academies'') under which the National Academies shall conduct a study
on the use of technology to reduce preventable maternal mortality and
severe maternal morbidity, and close racial and ethnic disparities in
maternal health outcomes in the United States. The study shall assess
current and future uses of artificial intelligence in maternity care,
including issues such as--
(1) the extent to which artificial intelligence
technologies are currently being used in maternal health care;
(2) the extent to which artificial intelligence
technologies have exacerbated racial or ethnic biases in
maternal health care;
(3) recommendations for reducing racial or ethnic biases in
artificial intelligence technologies used in maternal health
care;
(4) recommendations for potential applications of
artificial intelligence technologies that could improve
maternal health outcomes, particularly for minority women; and
(5) recommendations for privacy and security safeguards
that should implemented in the development of artificial
intelligence technologies in maternal health care.
(b) Report.--As a condition of any agreement under subsection (a),
the Administrator shall require that the National Academies transmit to
Congress a report on the results of the study under subsection (a) not
later than 24 months after the date of enactment of this Act.
SEC. 6. DEFINITIONS.
In this section:
(1) Maternal mortality.--The term ``maternal mortality''
means a death occurring during or within a 1-year period after
pregnancy caused by pregnancy or childbirth complications.
(2) Severe maternal mortality.--The term ``severe maternal
morbidity'' means an unexpected outcome caused by labor and
delivery of a woman that results in significant short-term or
long-term consequences to the health of the woman.
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