H.R. 8074

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8074 Introduced in House (IH)]

<DOC>

119th CONGRESS
2d Session
H. R. 8074

To end preventable maternal mortality and severe maternal morbidity in 
the United States and close disparities in maternal health outcomes, 
and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

March 25, 2026

Ms. Adams (for herself, Ms. Underwood, Mrs. McIver, Ms. Tlaib, Ms. 
Norton, Ms. Moore of Wisconsin, Mrs. Watson Coleman, Ms. Kamlager-Dove, 
Mr. Johnson of Georgia, Ms. Pressley, Mr. Ivey, Mr. Krishnamoorthi, 
Mrs. Cherfilus-McCormick, Mr. Menefee, Mr. Bell, Mr. Moulton, Ms. 
Clarke of New York, Ms. DelBene, Mr. Garamendi, Mr. Cohen, Ms. 
Stansbury, Mrs. Dingell, Ms. Jacobs, Mr. Figures, Mr. Horsford, Mr. 
Garcia of Illinois, Mr. Veasey, Mrs. Beatty, Mr. Smith of Washington, 
Ms. Sewell, Ms. Wilson of Florida, Mr. Jackson of Illinois, Mr. 
Conaway, Mr. Scott of Virginia, Mrs. Hayes, Ms. Craig, Mr. McGarvey, 
Mrs. Grijalva, Mr. Carson, Mr. Takano, Mrs. McBath, Mr. Latimer, Ms. 
Johnson of Texas, Mr. Soto, Mr. David Scott of Georgia, Ms. Barragan, 
Ms. McClellan, Mr. Schneider, Mr. Mullin, Ms. Strickland, Mr. Tonko, 
Ms. Dean of Pennsylvania, Mrs. Sykes, Ms. Salinas, Mr. Lieu, and Ms. 
Scanlon) introduced the following bill; which was referred to the 
Committee on Energy and Commerce

_______________________________________________________________________

A BILL

To end preventable maternal mortality and severe maternal morbidity in 
the United States and close disparities in maternal health outcomes, 
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 ``Kira Johnson Act''.

SEC. 2. SUSTAINED FUNDING FOR COMMUNITY-BASED ORGANIZATIONS TO ADVANCE 
MATERNAL HEALTH EQUITY.

(a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall award grants to 
eligible entities to establish or expand programs to advance maternal 
health equity.
(b) Timing.--Following the 1-year period described in subsection 
(d), the Secretary shall commence awarding the grants authorized by 
subsection (a).
(c) Eligible Entities.--To be eligible to seek a grant under this 
section, an entity shall be a community-based organization offering 
programs and resources aligned with evidence-based practices for 
improving maternal health outcomes for demographic groups with elevated 
rates of maternal mortality, severe maternal morbidity, maternal health 
disparities, or other adverse perinatal or childbirth outcomes.
(d) Outreach and Technical Assistance Period.--During the 1-year 
period beginning on the date of enactment of this Act, the Secretary 
shall--
(1) conduct outreach to encourage eligible entities to 
apply for grants under this section; and
(2) provide technical assistance to eligible entities on 
best practices for applying for grants under this section.
(e) Special Consideration.--
(1) Outreach.--In conducting outreach under subsection (d), 
the Secretary shall give special consideration to eligible 
entities that--
(A) are based in, and provide support for, 
communities with elevated rates of maternal mortality, 
severe maternal morbidity, maternal health disparities, 
or other adverse perinatal or childbirth outcomes, to 
the extent such data are available;
(B) are led by individuals from demographic groups 
with elevated rates of maternal mortality, severe 
maternal morbidity, maternal health disparities, or 
other adverse perinatal or childbirth outcomes; and
(C) offer programs and resources that are aligned 
with evidence-based practices for improving maternal 
health outcomes for individuals from demographic groups 
with elevated rates of maternal mortality, severe 
maternal morbidity, maternal health disparities, or 
other adverse perinatal or childbirth outcomes.
(2) Awards.--In awarding grants under this section, the 
Secretary shall give special consideration to eligible entities 
that--
(A) are described in subparagraphs (A), (B), and 
(C) of paragraph (1);
(B) offer programs and resources designed in 
consultation with and intended for individuals from 
demographic groups with elevated rates of maternal 
mortality, severe maternal morbidity, maternal health 
disparities, or other adverse perinatal or childbirth 
outcomes;
(C) offer programs and resources in the communities 
in which the respective eligible entities are located 
that--
(i) promote maternal mental health and 
maternal substance use disorder treatments and 
supports that are aligned with evidence-based 
practices for improving maternal mental and 
behavioral health outcomes for individuals from 
demographic groups with elevated rates of 
maternal mortality, severe maternal morbidity, 
maternal health disparities, or other adverse 
perinatal or childbirth outcomes;
(ii) address social determinants of 
maternal health;
(iii) promote evidence-based health 
literacy and pregnancy, childbirth, and 
parenting education;
(iv) provide support from perinatal health 
workers;
(v) provide culturally and linguistically 
congruent training to perinatal health workers;
(vi) conduct or support research on 
maternal health issues disproportionately 
impacting individuals from demographic groups 
with elevated rates of maternal mortality, 
severe maternal morbidity, maternal health 
disparities, or other adverse perinatal or 
childbirth outcomes;
(vii) offer group prenatal care or group 
postpartum care;
(viii) coordinate mutual aid efforts during 
infant formula shortages, including community 
milk depots, donor human milk banks and 
exchanges, and forums for community outreach 
and education;
(ix) provide support to individuals or 
family members of individuals who suffered a 
pregnancy loss, pregnancy-associated death, or 
pregnancy-related death; or
(x) operate midwifery practices that 
provide culturally and linguistically congruent 
maternal health care and support, including for 
the purposes of--
(I) supporting additional 
education, training, and certification 
programs, including support for 
distance learning;
(II) providing financial support to 
current and future midwives to address 
education costs, debts, and other 
needs;
(III) clinical site investments;
(IV) supporting preceptor 
development trainings;
(V) expanding the midwifery 
practice; or
(VI) related needs identified by 
the midwifery practice and described in 
the practice's application; and
(D) have developed other programs and resources 
that address community-specific needs for pregnant and 
postpartum individuals and are aligned with evidence-
based practices for improving maternal health outcomes 
for individuals from demographic groups with elevated 
rates of maternal mortality, severe maternal morbidity, 
maternal health disparities, or other adverse perinatal 
or childbirth outcomes.
(f) Technical Assistance.--The Secretary shall provide to grant 
recipients under this section technical assistance on--
(1) capacity building to establish or expand programs to 
advance maternal health equity;
(2) best practices in data collection, measurement, 
evaluation, and reporting; and
(3) planning for sustaining programs to advance maternal 
health equity after the period of the grant.
(g) Evaluation.--Not later than the end of fiscal year 2031, the 
Secretary shall submit to the Congress an evaluation of the grant 
program under this section that--
(1) assesses the effectiveness of outreach efforts during 
the application process in diversifying the pool of grant 
recipients;
(2) makes recommendations for future outreach efforts to 
diversify the pool of grant recipients for Department of Health 
and Human Services grant programs and funding opportunities 
related to maternal health;
(3) assesses the effectiveness of programs funded by grants 
under this section in improving maternal health outcomes for 
individuals from demographic groups with elevated rates of 
maternal mortality, severe maternal morbidity, maternal health 
disparities, or other adverse perinatal or childbirth outcomes, 
to the extent practicable; and
(4) makes recommendations for future Department of Health 
and Human Services grant programs and funding opportunities 
that deliver funding to community-based organizations that 
provide programs and resources that are aligned with evidence-
based practices for improving maternal health outcomes for 
individuals from demographic groups with elevated rates of 
maternal mortality, severe maternal morbidity, maternal health 
disparities, or other adverse perinatal or childbirth outcomes.
(h) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $100,000,000 for each of fiscal 
years 2027 through 2031.

SEC. 3. RESPECTFUL MATERNITY CARE TRAINING FOR ALL EMPLOYEES IN 
MATERNITY CARE SETTINGS.

Part B of title VII of the Public Health Service Act (42 U.S.C. 293 
et seq.) is amended by adding at the end the following new section:

``SEC. 742. RESPECTFUL MATERNITY CARE TRAINING FOR ALL EMPLOYEES IN 
MATERNITY CARE SETTINGS.

``(a) Grants.--The Secretary shall award grants for programs to 
reduce and prevent bias, racism, and discrimination in maternity care 
settings and to advance respectful, culturally and linguistically 
congruent, trauma-informed care.
``(b) Special Consideration.--In awarding grants under subsection 
(a), the Secretary shall give special consideration to applications for 
programs that would--
``(1) apply to all maternity care providers and any 
employees who interact with pregnant and postpartum individuals 
in the provider setting, including front desk employees, 
sonographers, schedulers, health care professionals, hospital 
or health system administrators, security staff, and other 
employees;
``(2) emphasize periodic, as opposed to one-time, trainings 
for all birthing professionals and employees described in 
paragraph (1);
``(3) address implicit bias, racism, and cultural humility;
``(4) be delivered in ongoing education settings for 
providers maintaining their licenses, with a preference for 
trainings that provide continuing education units;
``(5) include trauma-informed care best practices and an 
emphasis on shared decision making between providers and 
patients;
``(6) include antiracism training and programs;
``(7) be delivered in undergraduate programs that funnel 
into health professions schools;
``(8) be delivered in settings that apply to providers of 
the special supplemental nutrition program for women, infants, 
and children under section 17 of the Child Nutrition Act of 
1966;
``(9) integrate bias training in obstetric emergency 
simulation trainings or related trainings;
``(10) include training for emergency department employees 
and emergency medical technicians on recognizing warning signs 
for severe pregnancy-related complications;
``(11) offer training to all maternity care providers on 
the value of racially, ethnically, and professionally diverse 
maternity care teams to provide culturally and linguistically 
congruent care; or
``(12) be based on one or more programs designed by a 
historically Black college or university or other minority-
serving institution.
``(c) Application.--To seek a grant under subsection (a), an entity 
shall submit an application at such time, in such manner, and 
containing such information as the Secretary may require.
``(d) Reporting.--Each recipient of a grant under this section 
shall annually submit to the Secretary a report on the status of 
activities conducted using the grant, including, as applicable, a 
description of the impact of training provided through the grant on 
patient outcomes and patient experience for pregnant and postpartum 
individuals from racial and ethnic minority groups and their families.
``(e) Best Practices.--Based on the annual reports submitted 
pursuant to subsection (d), the Secretary--
``(1) shall produce an annual report on the findings 
resulting from programs funded through this section;
``(2) shall disseminate such report to all recipients of 
grants under this section and to the public; and
``(3) may include in such report findings on best practices 
for improving patient outcomes and patient experience for 
pregnant and postpartum individuals from racial and ethnic 
minority groups and their families in maternity care settings.
``(f) Definitions.--In this section:
``(1) The term `postpartum' means the 1-year period 
beginning on the last day of an individual's pregnancy.
``(2) The term `culturally and linguistically congruent' 
means in agreement with the preferred cultural values, beliefs, 
worldview, language, and practices of the health care consumer 
and other stakeholders.
``(3) The term `racial and ethnic minority group' has the 
meaning given such term in section 1707(g)(1).
``(g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $5,000,000 for each of fiscal 
years 2027 through 2031.''.

SEC. 4. STUDY ON REDUCING AND PREVENTING BIAS, RACISM, AND 
DISCRIMINATION IN MATERNITY CARE SETTINGS.

(a) In General.--The Secretary of Health and Human Services shall 
seek to enter into an agreement, not later than 90 days after the date 
of enactment of this Act, with the National Academies of Sciences, 
Engineering, and Medicine (referred to in this section as the 
``National Academies'') under which the National Academies agree to--
(1) 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
(2) not later than 24 months after the date of enactment of 
this Act--
(A) complete the study; and
(B) transmit a report on the results of the study 
to the Congress.
(b) Possible Topics.--The agreement entered into pursuant to 
subsection (a) may provide for the study of any of the following:
(1) The development of a scorecard or other evaluation 
standards for programs designed to reduce and prevent bias, 
racism, and discrimination in maternity care settings to assess 
the effectiveness of such programs in improving patient 
outcomes and patient experience for pregnant and postpartum 
individuals from racial and ethnic minority groups and their 
families.
(2) Determination of the types and frequency of training to 
reduce and prevent bias, racism, and discrimination in 
maternity care settings that are demonstrated to improve 
patient outcomes or patient experience for pregnant and 
postpartum individuals from racial and ethnic minority groups 
and their families.

SEC. 5. RESPECTFUL MATERNITY CARE COMPLIANCE PROGRAM.

(a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall award grants 
to accredited hospitals, health systems, and other maternity care 
settings to establish as an integral part of quality implementation 
initiatives within one or more hospitals or other birth settings a 
respectful maternity care compliance program.
(b) Program Requirements.--A respectful maternity care compliance 
program funded through a grant under this section shall--
(1) institutionalize mechanisms to allow patients receiving 
maternity care services, the families of such patients, or 
perinatal health workers supporting such patients to report 
instances of racism or evidence of bias on the basis of race, 
ethnicity, or another protected class;
(2) institutionalize response mechanisms through which 
representatives of the program can directly follow up with the 
patient, if possible, and the patient's family in a timely 
manner;
(3) prepare and make publicly available a hospital- or 
health system-wide strategy to reduce bias on the basis of 
race, ethnicity, or another protected class in the delivery of 
maternity care that includes--
(A) information on the training programs to reduce 
and prevent bias, racism, and discrimination on the 
basis of race, ethnicity, or another protected class 
for all employees in maternity care settings;
(B) information on the number of cases reported to 
the compliance program; and
(C) the development of methods to routinely assess 
the extent to which bias, racism, or discrimination on 
the basis of race, ethnicity, or another protected 
class is present in the delivery of maternity care to 
patients from racial and ethnic minority groups;
(4) develop mechanisms to routinely collect and publicly 
report hospital-level data related to patient-reported 
experience of care; and
(5) provide annual reports to the Secretary with 
information about each case reported to the compliance program 
over the course of the year containing such information as the 
Secretary may require, such as--
(A) deidentified demographic information on the 
patient in the case, such as race, ethnicity, gender 
identity, and primary language;
(B) the content of the report from the patient or 
the family of the patient to the compliance program;
(C) the response from the compliance program; and
(D) to the extent applicable, institutional changes 
made as a result of the case.
(c) Secretary Requirements.--
(1) Processes.--Not later than 180 days after the date of 
enactment of this Act, the Secretary shall establish processes 
for--
(A) disseminating best practices for establishing 
and implementing a respectful maternity care compliance 
program within a hospital or other birth setting;
(B) promoting coordination and collaboration 
between hospitals, health systems, and other maternity 
care delivery settings on the establishment and 
implementation of respectful maternity care compliance 
programs; and
(C) evaluating the effectiveness of respectful 
maternity care compliance programs on maternal health 
outcomes and patient and family experiences, especially 
for patients from racial and ethnic minority groups and 
their families.
(2) Study.--
(A) In general.--Not later than 2 years after the 
date of enactment of this Act, the Secretary shall, 
through a contract with an independent research 
organization, conduct a study on strategies to 
address--
(i) racism or bias on the basis of race, 
ethnicity, or another protected class in the 
delivery of maternity care services; and
(ii) successful implementation of 
respectful care initiatives.
(B) Components of study.--The study shall include 
the following:
(i) An assessment of the reports submitted 
to the Secretary from the respectful maternity 
care compliance programs pursuant to subsection 
(b)(5).
(ii) Based on such assessment, 
recommendations for potential accountability 
mechanisms related to cases of racism or bias 
on the basis of race, ethnicity, or another 
protected class in the delivery of maternity 
care services at hospitals and other birth 
settings. Such recommendations shall take into 
consideration medical and nonmedical factors 
that contribute to adverse patient experiences 
and maternal health outcomes.
(C) Report.--The Secretary shall submit to the 
Congress and make publicly available a report on the 
results of the study under this paragraph.
(d) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2027 through 2032.

SEC. 6. GAO REPORT.

(a) In General.--Not later than 2 years after the date of enactment 
of this Act and annually thereafter, the Comptroller General of the 
United States shall submit to the 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.
(b) Matters Included.--The report under subsection (a) shall 
include the following:
(1) Information regarding the extent to which hospitals, 
health systems, and other maternity care settings have elected 
to establish respectful maternity care compliance programs, 
including--
(A) which hospitals and other birth settings elect 
to establish compliance programs and when such programs 
are established;
(B) to the extent practicable, impacts of the 
establishment of such programs on maternal health 
outcomes and patient and family experiences in the 
hospitals and other birth settings that have 
established such programs, especially for patients from 
racial and ethnic minority groups and their families;
(C) information on geographic areas, and types of 
hospitals or other birth settings, where respectful 
maternity care compliance programs are not being 
established and information on factors contributing to 
decisions to not establish such programs; and
(D) recommendations for establishing respectful 
maternity care compliance programs in geographic areas, 
and types of hospitals or other birth settings, where 
such programs are not being established.
(2) Whether the funding made available to carry out this 
section has been sufficient and, if applicable, recommendations 
for additional appropriations to carry out this section.
(3) Such other information as the Comptroller General 
determines appropriate.

SEC. 7. DEFINITIONS.

In this Act:
(1) Culturally and linguistically congruent.--The term 
``culturally and linguistically congruent'', with respect to 
care or maternity care, means care that is in agreement with 
the preferred cultural values, beliefs, worldview, language, 
and practices of the health care consumer and other 
stakeholders.
(2) Maternal mortality.--The term ``maternal mortality'' 
means a death occurring during or within a 1-year period after 
pregnancy, caused by pregnancy-related or childbirth 
complications, including a suicide, overdose, or other death 
resulting from a mental health or substance use disorder 
attributed to or aggravated by pregnancy-related or childbirth 
complications.
(3) Perinatal health worker.--The term ``perinatal health 
worker'' means a nonclinical health worker focused on maternal 
or perinatal health, such as a doula, community health worker, 
peer supporter, lactation educator or counselor, nutritionist 
or dietitian, childbirth educator, social worker, home visitor, 
patient navigator or coordinator, or language interpreter.
(4) Postpartum.--The term ``postpartum'' refers to the 1-
year period beginning on the last day of the pregnancy of an 
individual.
(5) Pregnancy-associated death.--The term ``pregnancy-
associated death'' means a death of a pregnant or postpartum 
individual, by any cause, that occurs during, or within 1 year 
following, the individual's pregnancy, regardless of the 
outcome, duration, or site of the pregnancy.
(6) Pregnancy-related death.--The term ``pregnancy-related 
death'' means a death of a pregnant or postpartum individual 
that occurs during, or within 1 year following, the 
individual's pregnancy, from a pregnancy complication, a chain 
of events initiated by pregnancy, or the aggravation of an 
unrelated condition by the physiologic effects of pregnancy.
(7) Racial and ethnic minority group.--The term ``racial 
and ethnic minority group'' has the meaning given such term in 
section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
300u-6(g)(1)).
(8) Severe maternal morbidity.--The term ``severe maternal 
morbidity'' means a health condition, including mental health 
conditions and substance use disorders, attributed to or 
aggravated by pregnancy or childbirth that results in 
significant short-term or long-term consequences to the health 
of the individual who was pregnant.
(9) Social determinants of maternal health.--The term 
``social determinants of maternal health'' means nonclinical 
factors that impact maternal health outcomes.
<all>