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Title II — Research and data collection on Maternity Care

H.R. 2286 · 113th Congress · Jun 6, 2013 · Lineage

II Research and data collection on Maternity Care

Sec. 201 Maternity care health professional shortage areas

Section 332 of the Public Health Service Act (42 U.S.C. 254e) is amended by adding at the end the following new subsection:

“(k)

“(1) The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall designate maternity care health professional shortage areas in the States, publish a descriptive list of the area’s population groups, medical facilities, and other public facilities so designated, and at least annually review and, as necessary, revise such designations.

“(2) For purposes of paragraph (1), a complete descriptive list shall be published in the Federal Register not later than one year after the date of the enactment of the MOMS for the 21st Century Act and annually thereafter.

“(3) The provisions of subsections (b), (c), (e), (f), (g), (h), (i), and (j) (other than (j)(1)(B)) of this section shall apply to the designation of a maternity care health professional shortage area in a similar manner and extent as such provisions apply to the designation of health professional shortage areas, except in applying subsection (b)(3), the reference in such subsection to physicians shall be deemed to be a reference to nationally certified and State licensed obstetricians, family practice physicians who practice full-scope maternity care, certified nurse-midwives, certified midwives, certified professional midwives, and physician’s assistants who practice full scope maternity care.

“(4) For purposes of this subsection, the term maternity care health professional shortage area means—

“(A) an area in an urban or rural area (which need not conform to the geographic boundaries of a political subdivision and which is a rational area for the delivery of health services) which the Secretary determines has a shortage of providers of maternity care health services including those referenced in paragraph (3) or an urban or rural area that the Secretary determines has lost a significant number of such providers during the 10-year period beginning with 2004 or has no obstetrical providers licensed to provide operative obstetrical services;

“(B) an area in an urban or rural area (which need not conform to the geographic boundaries of a political subdivision and which is a rational area for the delivery of health services) which the Secretary determines has a shortage of hospital or labor and delivery units, hospital birth center units, or freestanding birth centers or an area that lost a significant number of these units during the 10-year period beginning with 2003; or

“(C) a population group which the Secretary determines has such a shortage of providers or facilities.”

Sec. 202 Expansion of CDC Prevention Research Centers program to include Centers on Optimal Maternity Outcomes

(a)
In general— Not later than one year after the date of the enactment of this Act, the Secretary of Health and Human Services, shall support the establishment of 2 additional Prevention Research Centers under the Prevention Research Center Program administered by the Centers for Disease Control and Prevention. Such additional centers shall each be known as a Center for Excellence on Optimal Maternity Outcomes.
(b)
Research— Each Center for Excellence on Optimal Maternity Outcomes shall—
(1)
conduct at least one focused program of research to improve maternity outcomes, including the reduction of cesarean birth rates, elective inductions, prematurity rates, and low birth weight rates within an underserved population that has a disproportionately large burden of suboptimal maternity outcomes, including maternal mortality and morbidity, infant mortality, prematurity, or low birth weight;
(2)
work with partners on special interest projects, as specified by the Centers for Disease Control and Prevention and other relevant agencies within the Department of Health and Human Services, and on projects funded by other sources; and
(3)
involve a minimum of two distinct birth setting models, such as a hospital labor and delivery model and freestanding birth center model; or a hospital labor and delivery model and planned home birth model.
(c)
Interdisciplinary providers— Each Center for Excellence on Optimal Maternity Outcomes shall include the following interdisciplinary providers of maternity care:
(1)
Obstetrician-gynecologists.
(2)
Certified nurse midwives or certified midwives.
(3)
At least two of the following providers:
(A)
Family practice physicians.
(B)
Nurse practitioners.
(C)
Physician assistants.
(D)
Certified professional midwives.
(d)
Services— Research conducted by each Center for Excellence on Optimal Maternity Outcomes shall include at least 2 (and preferably more) of the following supportive provider services:
(1)
Mental health.
(2)
Doula labor support.
(3)
Nutrition education.
(4)
Childbirth education.
(5)
Social work.
(6)
Physical therapy or occupation therapy.
(7)
Substance abuse services.
(8)
Home visiting.
(e)
Coordination— The programs of research at each of the two Centers of Excellence on Optimal Maternity Outcomes shall compliment and not replicate the work of the other.
(f)
Authorization of appropriations— There is authorized to be appropriated to carry out this section $2,000,000 for each of the fiscal years 2014 through 2018.

Sec. 203 Expanding models to be tested by Center for Medicare and Medicaid Innovation to include maternity care models

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 clause:

“(xxi) Promoting evidence-based models of prenatal care that have been associated with reductions in maternal and infant health disparities; incorporating the use of doula and promotoras support; and advancing out-of-hospital births, including births at home and in freestanding birth centers.”