Momnibus Act

This provision establishes a task force, convened by the Secretary of Health and Human Services, to develop strategies and coordinate efforts across federal agencies and stakeholders to eliminate preventable maternal mortality, severe maternal morbidity, and maternal health disparities. The task force will include ex officio members from various federal departments and agencies, as well as appointed members representing patients, community-based organizations, Indian health systems, perinatal health workers, and maternity care providers. It will address topics like barriers to care, housing, nutrition, environmental impacts, and domestic violence, and will report annually to Congress.

This section authorizes $100,000,000 annually for fiscal years 2027 through 2031 for grants to eligible entities, including community-based organizations and Tribal entities, to address social determinants of maternal health. These grants aim to eliminate maternal mortality, severe maternal morbidity, and maternal health disparities by funding initiatives related to housing, transportation, nutrition, employment, environmental conditions, and intimate partner violence. Priority is given to entities in areas with high rates of adverse maternal health outcomes and high poverty rates.

This provision amends the Child Nutrition Act of 1966 to extend eligibility for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) for new mothers. Specifically, it extends the postpartum period for WIC eligibility from six months to 24 months and the breastfeeding period from one year to 24 months. The Secretary is required to report on the effects of these extensions on maternal and infant health outcomes, breastfeeding rates, and family experiences.

This section authorizes $100,000,000 annually for fiscal years 2027 through 2031 for grants to community-based organizations that establish or expand programs to advance maternal health equity. The Secretary of Health and Human Services will conduct outreach and provide technical assistance, prioritizing organizations in communities with elevated rates of maternal mortality and disparities, especially those led by individuals from affected demographic groups. Programs may include mental health support, social determinants, health literacy, perinatal health worker support, and midwifery practices.

This section amends the Public Health Service Act to authorize $5,000,000 annually for fiscal years 2027 through 2031 for grants to programs that reduce and prevent bias, racism, and discrimination in maternity care settings. The grants will support training for all employees, from front desk staff to health care professionals, emphasizing periodic, trauma-informed, and anti-racism training. Special consideration is given to programs that integrate bias training into obstetric emergency simulations and those designed by minority-serving institutions.

This section directs the Secretary of Health and Human Services to contract with the National Academies of Sciences, Engineering, and Medicine to conduct a study on the design and implementation of programs aimed at reducing bias, racism, and discrimination in maternity care. The study will assess the effectiveness of such programs in improving patient outcomes and experiences for pregnant and postpartum individuals from racial and ethnic minority groups. It will also determine the types and frequency of training that are most effective.

This section authorizes grants to hospitals and other maternity care settings to establish respectful maternity care compliance programs. These programs must include mechanisms for patients, families, or perinatal health workers to report instances of racism or bias, institutionalize timely response mechanisms, develop and publicly share strategies to reduce bias, collect and report patient-reported experience data, and provide annual reports to the Secretary. The Secretary is also mandated to establish processes for disseminating best practices and evaluating program effectiveness, and to conduct a study on strategies to address racism/bias and successful implementation of respectful care initiatives.

This section mandates the Comptroller General of the United States (GAO) to submit an initial report within two years of enactment, and annually thereafter, on the establishment of respectful maternity care compliance programs. The report will assess the extent to which hospitals and other settings establish these programs, their impact on maternal health outcomes and patient experiences (especially for racial and ethnic minority groups), and factors contributing to non-establishment. It will also evaluate the sufficiency of funding and provide recommendations for expanding program adoption.

This section mandates the Secretary of Veterans Affairs to submit annual reports to Congress until September 30, 2031, detailing activities and data on maternal health outcomes for veterans receiving VA care. It specifically requests data on dually eligible patients (VA and Indian Health Service) and recommendations to improve outcomes for veterans from demographic groups with elevated maternal health disparities. It also authorizes $15,000,000 annually for fiscal years 2027 through 2031 for VA maternity care coordination and related programs, supplementing existing funds.

This section directs the Secretary of Health and Human Services to issue guidance to States within two years to educate providers and insurers on the value of diverse and multidisciplinary maternal health care provider models. This guidance will encourage recruitment of diverse providers, incorporation of midwives and perinatal health workers, and provision of culturally congruent care. Additionally, the Director of NIH is mandated to conduct a study on best practices in respectful and culturally congruent maternity care, reporting findings and recommendations to Congress within two years.

This section amends the Public Health Service Act to authorize $15,000,000 annually for fiscal years 2027 through 2031 for grants to establish or expand programs that train physician assistants, perinatal health workers, and midwives. Priority is given to programs committed to recruiting and retaining students and faculty from racial and ethnic minority groups, those planning to practice in health professional shortage areas or areas with significant maternal health disparities, and those including bias/racism training in their curriculum. Grant recipients must report annually on student demographics and career placement.

This section amends the Public Health Service Act to authorize $15,000,000 annually for fiscal years 2027 through 2031 for grants to schools of nursing. These grants will provide scholarships to students seeking to become nurse practitioners, certified nurse-midwives, or clinical nurse specialists with a focus on maternal and perinatal health. Priority is given to schools that recruit diverse students, partner with practice settings in health professional shortage areas, target areas with maternal health disparities, and include bias/racism training in their curriculum. Schools must report annually on student demographics and career placement.

This section mandates the Comptroller General of the United States (GAO) to submit a report within two years of enactment, and every five years thereafter, on barriers to maternal health education and access to care. The report will assess barriers to entering and completing midwifery and other maternal health professional education programs, particularly for low-income women and women from racial and ethnic minority groups. It will also examine disparities in access to various maternal care providers, stratified by demographics, and recommend ways to promote greater access and compensation equity for perinatal health workers.

This section amends the Public Health Service Act to authorize $10,000,000 annually for fiscal years 2027 through 2031 for grants to State, Tribal, and Urban Indian maternal mortality review committees (MMRCs). These grants will help MMRCs increase the diversity of their membership, particularly with community members from racial and ethnic minority groups and those with lived experience of maternal mortality or severe morbidity. Funds can address participation barriers like training and compensation. MMRCs will also establish outreach initiatives, focusing on minority women, and release public reports assessing their review processes and the impact of these grants on diversity and engagement.

This section amends the Public Health Service Act to expand the scope of data collection and review for maternal mortality review committees (MMRCs). It requires MMRCs, to the extent practicable, to review cases of severe maternal morbidity and deaths from mental health conditions or substance use disorders attributed to pregnancy or childbirth complications. It also mandates consultation with local community-based organizations representing affected demographic groups to ensure nonclinical factors contributing to pregnancy-related deaths are appropriately considered.

This section mandates the Secretary of Health and Human Services, through CMS and AHRQ, to consult with stakeholders to review existing maternal health data collection processes and quality measures, and to make recommendations for improvement. The review will cover State and Tribal data practices, funding adequacy, and current quality measures for prenatal, labor, delivery, and postpartum care. It will assess how measures account for patient experience and racial/ethnic disparities, and recommend new authorities for maternal mortality review committees.

This section directs the Secretary of Health and Human Services to contract with an independent research organization or Tribal Epidemiology Center to conduct a comprehensive study on maternal mortality, severe maternal morbidity, and other adverse perinatal outcomes among American Indian and Alaska Native (AI/AN) individuals. The study will examine unique causes, listen to AI/AN stories, distinguish care settings (IHS, Tribal, Urban Indian, and external facilities), review data collection, assess mental health and substance use, consider social determinants and historical mistreatment, and make recommendations to improve outcomes and reduce misclassification.

This section authorizes $10,000,000 annually for fiscal years 2027 through 2031 for grants to research centers, health professions schools, and other entities at minority-serving institutions (MSIs). These grants will fund research into specific aspects of the maternal health crisis among pregnant and postpartum individuals from racial and ethnic minority groups. Research may include systematic listening to patient stories, assessing misclassification and disparities among Hispanic individuals, and lactation education to promote diversity in breastfeeding expertise. The Secretary will provide outreach and technical assistance to MSIs.

This section authorizes $25,000,000 annually for fiscal years 2027 through 2031 for grants to eligible entities (community-based organizations, nonprofits, providers, state/local governments, Tribal entities) to address maternal mental health conditions and substance use disorders. Priority is given to entities partnering with community-based organizations, operating in high-need areas, or health professional shortage areas. Funds can be used for integrating mental health into primary care, group prenatal/postpartum care, suicide prevention, provider training, and developing resources for mental health support.

This section amends the Public Health Service Act to authorize $15,000,000 annually for fiscal years 2027 through 2031 for grants to establish or expand programs that train mental or behavioral health care providers specializing in maternal mental health conditions or substance use disorders. Priority is given to entities recruiting diverse students, planning to practice in health professional shortage areas or areas with significant maternal health disparities, and including bias/racism training in their curriculum. Grant recipients must report annually on student demographics and career placement.

This provision mandates a 25% decrease in Edward Byrne Memorial Justice Grant Program funds for any State that, six months after enactment, does not have laws restricting the use of restraints on pregnant individuals in prison substantially similar to federal law (18 U.S.C. 4322). Amounts withheld from non-compliant states will be reallocated to compliant states. This aims to end the practice of shackling pregnant incarcerated individuals.

This section directs the Attorney General, through the Bureau of Prisons (BOP), to establish model programs in at least six BOP facilities within one year to optimize maternal health outcomes for pregnant and postpartum incarcerated individuals. These 5-year programs, developed in consultation with stakeholders, may include access to perinatal health workers, healthy food, nutrition counseling, training for correctional officers and medical personnel, counseling for various health conditions, childbirth education, opportunities for mother-child bonding, and reentry assistance. Facilities are prioritized based on the number of pregnant/postpartum individuals and commitment to exemplary programs.

This section authorizes $10,000,000 annually for fiscal years 2027 through 2031 for Justice for Incarcerated Moms grants to States. These grants, awarded by the Attorney General through the Bureau of Justice Assistance, will establish or expand programs in State and local prisons and jails for pregnant and postpartum incarcerated individuals. Programs mirror those in BOP facilities (Sec. 802), including access to perinatal health workers, nutrition, training for staff, counseling, education, bonding opportunities, and reentry assistance. Priority is given to states with high numbers of pregnant/postpartum individuals and those committed to exemplary programs.

This section mandates the Comptroller General of the United States (GAO) to submit a report within two years of enactment on adverse maternal and infant health outcomes among incarcerated individuals, with a focus on racial and ethnic disparities. The report will include data on pregnant individuals in BOP facilities, pregnancy-related deaths, severe maternal morbidity, preterm/low-birthweight births, and racial/ethnic disparities across federal, state, and local facilities. It will also assess barriers to data collection, implications of Medicaid ineligibility, policies on illicit drug use during pregnancy, unique causes of adverse outcomes, and recommendations for improvement.

This section amends the Social Security Act to allow for the adoption and use of telehealth tools for screening, monitoring, and managing common health complications during pregnancy and for up to one year postpartum, specifically focusing on the Medicaid program (Title XIX). The amendment takes effect one year after enactment, enabling states to test payment models that incorporate telehealth for maternal care.

This section authorizes $6,000,000 annually for fiscal years 2027 through 2031 for grants to eligible entities to develop and expand technology-enabled collaborative learning and capacity building models (e.g., Project ECHO). These models will train maternal health care providers and students on safety, quality, bias, mental health screening, public health emergencies, social determinants, and remote patient monitoring. Grants will target health professional shortage areas, high maternal mortality areas, rural/underserved areas, and medically underserved populations. The Secretary will provide technical assistance and report on the program's effectiveness.

This section authorizes $6,000,000 annually for fiscal years 2027 through 2031 for grants to eligible entities to reduce maternal health disparities by increasing access to digital tools. This includes provider-facing technologies like early warning systems and clinical decision support mechanisms, as well as consumer digital tools such as mobile apps and patient portals. Priority is given to entities in areas with elevated maternal mortality/morbidity, health professional shortage areas, or rural/underserved areas, and those promoting technology that addresses disparities. The Secretary will provide technical assistance and report on the program's effectiveness and recommendations for future policy.

This section directs the Secretary of Health and Human Services to contract with the National Academies of Sciences, Engineering, and Medicine to conduct a study on the use of technology and patient monitoring devices in maternity care. The study will specifically examine the impact of innovative technology (including AI) and patient monitoring devices (like pulse oximeters) on racial or ethnic biases in maternal health care. It will identify best practices for reducing bias, for using technology with racial and ethnic minority groups, and for privacy/security safeguards. A report on the study's results is due to Congress within 24 months.

This section establishes the Perinatal Care Alternative Payment Model Demonstration Project for fiscal years 2027 through 2031. The Secretary of Health and Human Services, through CMS, will allow States to test alternative payment models under Medicaid and CHIP for maternity care. The project will coordinate with stakeholders and consider models designed to improve outcomes for demographic groups with elevated disparities, stratify patients by risk, establish evidence-based quality metrics, include nonhospital birth settings, address social determinants, and incorporate diverse maternity care teams and mental health considerations. The Secretary will evaluate the project's impact on outcomes, spending, and patient experience, and report to Congress.

This section authorizes significant funding for various CDC programs and NIH to enhance data collection, surveillance, and research on maternal health during public health emergencies. Specifically, it authorizes $100M for Surveillance for Emerging Threats to Mothers and Babies, $30M for ERASE MM, $45M for PRAMS (to expand surveys and add questions on respectful care), and $15M for NIH's National Institute of Child Health and Human Development. The goal is to understand and mitigate the impact of emergencies and infectious diseases on pregnant/postpartum individuals and newborns, with a focus on racial/ethnic minority groups.

This section requires the Secretary of Health and Human Services, through CDC and CMS, to publicly disclose data collected through federal surveillance systems during public health emergencies, specifically regarding pregnant and postpartum individuals. This data must include diagnostic testing, confirmed cases, hospitalizations, deaths, and other health outcomes related to infectious disease outbreaks, disaggregated by race, ethnicity, gender, primary language, geography, and socioeconomic status. The data must be updated monthly during emergencies and one month after their end, with strict privacy protections. Guidance will be issued to states and local health departments to ensure comprehensive demographic data collection by laboratories.

This section directs the Director of the Centers for Disease Control and Prevention (CDC) to conduct public health education campaigns during public health emergencies. These campaigns will ensure that pregnant and postpartum individuals, their employers, and their health care providers receive accurate, evidence-based information on maternal and infant health risks during the emergency. A particular focus is placed on reaching pregnant and postpartum individuals in underserved communities.

This section establishes a task force, convened by the Secretary of Health and Human Services, to develop and update federal recommendations for respectful, responsive, and empowering maternity care during public health emergencies. The task force will address measures for facilitating respectful care, telehealth, specialized care for high-risk pregnancies, diagnostic testing, birthing companions, newborn separation, breastfeeding, licensure/reimbursement for midwives, support for perinatal health workers, mental/behavioral health, intimate partner violence, hospital capacity, childcare, and addressing racism/bias. It will include representatives from various federal agencies, public health officials, community organizations, providers, and patients.

This section establishes a grant program, within 180 days of enactment, to protect vulnerable individuals (pregnant, postpartum, or under 3 years old) from climate change risks like extreme heat, air pollution, and extreme weather. The Secretary of Health and Human Services will award competitive grants to 10 covered entities (consortia including community-based organizations) for initiatives to identify and mitigate these risks. Funds can be used for provider training, perinatal health worker support, enhanced monitoring, direct financial assistance, housing/transportation/evacuation aid, and urban forestry initiatives. Priority is given to entities serving areas with high climate vulnerability, pollution, poverty, or maternal health disparities.

This section establishes a grant program, within one year of enactment, to provide $5,000,000 for fiscal years 2027 through 2030 to health profession schools (medical, nursing, midwifery, PA programs, etc.). These grants will support the development and integration of education and training programs for identifying and addressing risks associated with climate change for vulnerable individuals (pregnant, postpartum, young children) and those intending to become pregnant. Training will cover how climate risks affect these groups, racial/ethnic disparities, patient counseling, mitigation strategies, and implicit bias. Schools must engage with vulnerable individuals and stakeholder organizations in program development.

This section establishes the Consortium on Birth and Climate Change Research within the National Institutes of Health (NIH) within one year of enactment. The Consortium will coordinate research across NIH institutes, centers, and offices on climate change risks for vulnerable individuals. Its duties include establishing research priorities (focusing on disparities and mitigation strategies), identifying data gaps, fostering collaborations, identifying funding opportunities for diverse researchers and community organizations, and increasing public awareness. Membership will include representatives from key NIH institutes (e.g., Environmental Health Sciences, Minority Health, Child Health and Human Development).

This section directs the Secretary of Health and Human Services, through the CDC Director, to develop a strategy for designating areas with a high risk of adverse maternal and infant health outcomes due to climate change risks. The strategy will establish a process to identify these 'risk zones' by considering environmental factors (air pollution, extreme heat), healthcare access, language proficiency, insurance status, racial/ethnic disparities, socioeconomic status (poverty, unemployment, income, education), and access to housing, transportation, and nutrition. It will identify existing mapping tools, data gaps, and recommend additional monitoring networks and funding. The strategy must be published within 18 months after a public comment period.

This section amends the Public Health Service Act to codify and authorize $73,400,000 annually for fiscal years 2027 through 2032 for the existing 'Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone Initiative' (IMPROVE Initiative) at the National Institutes of Health (NIH). The Initiative's objectives are to advance research to reduce preventable causes of maternal mortality and severe maternal morbidity, reduce health disparities, and improve health for pregnant and postpartum women. It uses an integrated approach to understand factors affecting maternal health and targets disparities through community-based interventions and identifying underlying biological mechanisms.

This section amends the Public Health Service Act to expand the scope and funding of the existing awareness campaign under Section 313 to include pregnant and postpartum individuals. It increases the authorized appropriation for the campaign to $17,000,000 annually for fiscal years 2027 through 2031. The campaign will promote maternal vaccinations, with a focus on racial and ethnic minority groups, and will involve prenatal, obstetric, and pediatric providers. Additionally, Section 317(k)(1)(E) is amended to include increasing vaccination rates of pregnant and postpartum individuals and their children as a key activity.