| 1 | 1 | | I |
|---|
| 2 | 2 | | 119THCONGRESS |
|---|
| 3 | 3 | | 1 |
|---|
| 4 | 4 | | STSESSION H. R. 1254 |
|---|
| 5 | 5 | | To improve obstetric emergency care. |
|---|
| 6 | 6 | | IN THE HOUSE OF REPRESENTATIVES |
|---|
| 7 | 7 | | FEBRUARY12, 2025 |
|---|
| 8 | 8 | | Ms. K |
|---|
| 9 | 9 | | ELLYof Illinois (for herself, Mrs. KIM, Ms. SCHRIER, and Mr. MEUSER) |
|---|
| 10 | 10 | | introduced the following bill; which was referred to the Committee on En- |
|---|
| 11 | 11 | | ergy and Commerce |
|---|
| 12 | 12 | | A BILL |
|---|
| 13 | 13 | | To improve obstetric emergency care. |
|---|
| 14 | 14 | | Be it enacted by the Senate and House of Representa-1 |
|---|
| 15 | 15 | | tives of the United States of America in Congress assembled, 2 |
|---|
| 16 | 16 | | SECTION 1. SHORT TITLE. 3 |
|---|
| 17 | 17 | | This Act may be cited as the ‘‘Rural Obstetrics Read-4 |
|---|
| 18 | 18 | | iness Act’’. 5 |
|---|
| 19 | 19 | | SEC. 2. OBSTETRIC EMERGENCY TRAINING PROGRAM. 6 |
|---|
| 20 | 20 | | Section 330O of the Public Health Service Act (42 7 |
|---|
| 21 | 21 | | U.S.C. 254c–21) is amended— 8 |
|---|
| 22 | 22 | | (1) in subsection (a)— 9 |
|---|
| 23 | 23 | | (A) in paragraph (3), by striking ‘‘; and’’ 10 |
|---|
| 24 | 24 | | and inserting a semicolon; 11 |
|---|
| 25 | 25 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 26 | 26 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 2 |
|---|
| 27 | 27 | | •HR 1254 IH |
|---|
| 28 | 28 | | (B) in paragraph (4), by striking the pe-1 |
|---|
| 29 | 29 | | riod and inserting ‘‘; and’’; and 2 |
|---|
| 30 | 30 | | (C) by adding at the end the following: 3 |
|---|
| 31 | 31 | | ‘‘(5) developing, and facilitating access to, an 4 |
|---|
| 32 | 32 | | evidence-based program to train practitioners in 5 |
|---|
| 33 | 33 | | rural health care facilities without dedicated obstet-6 |
|---|
| 34 | 34 | | ric units to provide emergency obstetric services dur-7 |
|---|
| 35 | 35 | | ing pregnancy, labor, delivery, or the postpartum pe-8 |
|---|
| 36 | 36 | | riod, including training on how to prepare for, iden-9 |
|---|
| 37 | 37 | | tify, stabilize, and safely transfer, as appropriate 10 |
|---|
| 38 | 38 | | and within the scope of practice of an individual 11 |
|---|
| 39 | 39 | | practitioner, a woman experiencing labor, delivery, 12 |
|---|
| 40 | 40 | | obstetric hemorrhage, severe hypertension, cardiac 13 |
|---|
| 41 | 41 | | conditions, perinatal mental health conditions, sub-14 |
|---|
| 42 | 42 | | stance use, sepsis, or other conditions, as appro-15 |
|---|
| 43 | 43 | | priate.’’; 16 |
|---|
| 44 | 44 | | (2) by redesignating subsections (c) and (d) as 17 |
|---|
| 45 | 45 | | subsections (d) and (e), respectively; 18 |
|---|
| 46 | 46 | | (3) by inserting after subsection (b) the fol-19 |
|---|
| 47 | 47 | | lowing: 20 |
|---|
| 48 | 48 | | ‘‘(c) T |
|---|
| 49 | 49 | | RAININGPROGRAM FOR ELIGIBLEPRACTI-21 |
|---|
| 50 | 50 | | TIONERS INRURALHEALTHCAREFACILITIES.—A train-22 |
|---|
| 51 | 51 | | ing program described in subsection (a)(5) shall include 23 |
|---|
| 52 | 52 | | an assessment of obstetric training needs for rural health 24 |
|---|
| 53 | 53 | | care facilities without dedicated obstetric units. In devel-25 |
|---|
| 54 | 54 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 55 | 55 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 3 |
|---|
| 56 | 56 | | •HR 1254 IH |
|---|
| 57 | 57 | | oping the training program, a recipient of a grant under 1 |
|---|
| 58 | 58 | | such subsection shall— 2 |
|---|
| 59 | 59 | | ‘‘(1) work in consultation with at least one rep-3 |
|---|
| 60 | 60 | | resentative from a national medical society that has 4 |
|---|
| 61 | 61 | | experience or expertise in rural health care delivery 5 |
|---|
| 62 | 62 | | in each of the fields of gynecology and obstetrics, 6 |
|---|
| 63 | 63 | | emergency medicine, family medicine, and anesthesi-7 |
|---|
| 64 | 64 | | ology; and 8 |
|---|
| 65 | 65 | | ‘‘(2) facilitate access to obstetric readiness 9 |
|---|
| 66 | 66 | | training via regional training partnerships and tech-10 |
|---|
| 67 | 67 | | nical assistance to rural health care facilities.’’; and 11 |
|---|
| 68 | 68 | | (4) in subsection (e), as so redesignated, by 12 |
|---|
| 69 | 69 | | adding at the end the following: ‘‘In addition to 13 |
|---|
| 70 | 70 | | amounts appropriated under the previous sentence, 14 |
|---|
| 71 | 71 | | for grants for the purpose described in subsection 15 |
|---|
| 72 | 72 | | (a)(5), there are authorized to be appropriated 16 |
|---|
| 73 | 73 | | $5,000,000 for the period of fiscal years 2026 17 |
|---|
| 74 | 74 | | through 2028’’. 18 |
|---|
| 75 | 75 | | SEC. 3. GRANT FUNDING FOR EQUIPMENT AND SUPPLIES. 19 |
|---|
| 76 | 76 | | Part D of title III of the Public Health Service Act 20 |
|---|
| 77 | 77 | | (42 U.S.C. 254b et seq.) is amended by inserting after 21 |
|---|
| 78 | 78 | | section 330A–2 the following: 22 |
|---|
| 79 | 79 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 80 | 80 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 4 |
|---|
| 81 | 81 | | •HR 1254 IH |
|---|
| 82 | 82 | | ‘‘SEC. 330A–3. PROGRAM OF SUPPORT FOR OBSTETRIC 1 |
|---|
| 83 | 83 | | SERVICES. 2 |
|---|
| 84 | 84 | | ‘‘(a) I |
|---|
| 85 | 85 | | NGENERAL.—The Secretary shall award 3 |
|---|
| 86 | 86 | | grants, contracts, or cooperative agreements to eligible en-4 |
|---|
| 87 | 87 | | tities to integrate obstetric readiness training curriculum 5 |
|---|
| 88 | 88 | | into rural health care settings, build workforce capacity, 6 |
|---|
| 89 | 89 | | and purchase equipment necessary to manage obstetric 7 |
|---|
| 90 | 90 | | emergencies. 8 |
|---|
| 91 | 91 | | ‘‘(b) U |
|---|
| 92 | 92 | | SE OFFUNDS.—A recipient of funds under 9 |
|---|
| 93 | 93 | | this section shall use such funds for the purpose described 10 |
|---|
| 94 | 94 | | in subsection (a), which may include any of the following: 11 |
|---|
| 95 | 95 | | ‘‘(1) Purchasing or providing equipment and 12 |
|---|
| 96 | 96 | | technical assistance to train practitioners who are 13 |
|---|
| 97 | 97 | | not specialized in obstetrics in preparing for, identi-14 |
|---|
| 98 | 98 | | fying, stabilizing, and transferring, as appropriate 15 |
|---|
| 99 | 99 | | and within the scope of practice of the practitioner, 16 |
|---|
| 100 | 100 | | individuals experiencing obstetric emergencies. 17 |
|---|
| 101 | 101 | | ‘‘(2) Purchasing or providing equipment nec-18 |
|---|
| 102 | 102 | | essary to prepare for, identify, stabilize, or transfer, 19 |
|---|
| 103 | 103 | | as appropriate, individuals experiencing obstetric 20 |
|---|
| 104 | 104 | | emergencies. 21 |
|---|
| 105 | 105 | | ‘‘(3) Developing and carrying out protocols for 22 |
|---|
| 106 | 106 | | transfer of patients to other facilities and network 23 |
|---|
| 107 | 107 | | engagement with other facilities. 24 |
|---|
| 108 | 108 | | ‘‘(4) Hiring additional personnel or paying the 25 |
|---|
| 109 | 109 | | salaries of personnel. 26 |
|---|
| 110 | 110 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 111 | 111 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 5 |
|---|
| 112 | 112 | | •HR 1254 IH |
|---|
| 113 | 113 | | ‘‘(5) Establishing training opportunities to en-1 |
|---|
| 114 | 114 | | able non-obstetric health professionals to gain expo-2 |
|---|
| 115 | 115 | | sure to, and expertise in, the delivery of obstetric 3 |
|---|
| 116 | 116 | | services, including through clinical rotations, fellow-4 |
|---|
| 117 | 117 | | ships, or cross-training clinicians in other specialties. 5 |
|---|
| 118 | 118 | | ‘‘(6) Enabling clinical educators to coordinate, 6 |
|---|
| 119 | 119 | | develop, and implement comprehensive interdiscipli-7 |
|---|
| 120 | 120 | | nary trainings, including team-based simulation 8 |
|---|
| 121 | 121 | | training for providers who may need to respond to 9 |
|---|
| 122 | 122 | | an obstetric emergency. 10 |
|---|
| 123 | 123 | | ‘‘(c) E |
|---|
| 124 | 124 | | LIGIBLEENTITIES.—To be eligible to receive 11 |
|---|
| 125 | 125 | | a grant under this section, an entity shall— 12 |
|---|
| 126 | 126 | | ‘‘(1) be— 13 |
|---|
| 127 | 127 | | ‘‘(A) a rural hospital, critical access hos-14 |
|---|
| 128 | 128 | | pital (as determined under section 1820(c)(2) 15 |
|---|
| 129 | 129 | | of the Social Security Act), or a rural emer-16 |
|---|
| 130 | 130 | | gency hospital (as defined in section 17 |
|---|
| 131 | 131 | | 1861(kkk)(2) of the Social Security Act) that is 18 |
|---|
| 132 | 132 | | located in a maternity care health professional 19 |
|---|
| 133 | 133 | | target area or a rural area (as defined by the 20 |
|---|
| 134 | 134 | | Secretary); or 21 |
|---|
| 135 | 135 | | ‘‘(B) a consortium of 3 entities that in-22 |
|---|
| 136 | 136 | | cludes at least 2 entities described in subpara-23 |
|---|
| 137 | 137 | | graph (A); and 24 |
|---|
| 138 | 138 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 139 | 139 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 6 |
|---|
| 140 | 140 | | •HR 1254 IH |
|---|
| 141 | 141 | | ‘‘(2) agree to carry out the program described 1 |
|---|
| 142 | 142 | | in subsection (a), in coordination with other feder-2 |
|---|
| 143 | 143 | | ally funded maternal and child health programs, to 3 |
|---|
| 144 | 144 | | the extent practicable, and in consultation with other 4 |
|---|
| 145 | 145 | | maternal and child health programs in the same geo-5 |
|---|
| 146 | 146 | | graphic area. 6 |
|---|
| 147 | 147 | | ‘‘(d) D |
|---|
| 148 | 148 | | EFINITIONS.—In this section— 7 |
|---|
| 149 | 149 | | ‘‘(1) the term ‘maternity care health profes-8 |
|---|
| 150 | 150 | | sional target area’ means a primary care health pro-9 |
|---|
| 151 | 151 | | fessional shortage area that is experiencing a short-10 |
|---|
| 152 | 152 | | age of maternity health care professionals, as identi-11 |
|---|
| 153 | 153 | | fied under section 332(k); and 12 |
|---|
| 154 | 154 | | ‘‘(2) the term ‘rural area’ has the meaning 13 |
|---|
| 155 | 155 | | given such term by the Federal Office of Rural 14 |
|---|
| 156 | 156 | | Health Policy. 15 |
|---|
| 157 | 157 | | ‘‘(e) A |
|---|
| 158 | 158 | | UTHORIZATION OF APPROPRIATIONS.—To 16 |
|---|
| 159 | 159 | | carry out this section, there is authorized to be appro-17 |
|---|
| 160 | 160 | | priated $15,000,000 for the period of fiscal years 2026 18 |
|---|
| 161 | 161 | | through 2029.’’. 19 |
|---|
| 162 | 162 | | SEC. 4. PILOT PROGRAM FOR TELECONSULTATION. 20 |
|---|
| 163 | 163 | | Part D of title III of the Public Health Service Act 21 |
|---|
| 164 | 164 | | (42 U.S.C. 254b et seq.), is amended by inserting after 22 |
|---|
| 165 | 165 | | section 330A–3, as inserted by section 3, the following: 23 |
|---|
| 166 | 166 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 167 | 167 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 7 |
|---|
| 168 | 168 | | •HR 1254 IH |
|---|
| 169 | 169 | | ‘‘SEC. 330A–4. PILOT PROGRAM FOR TELECONSULTATION. 1 |
|---|
| 170 | 170 | | ‘‘(a) I |
|---|
| 171 | 171 | | NGENERAL.—The Secretary, acting through 2 |
|---|
| 172 | 172 | | the Administrator of the Health Resources and Services 3 |
|---|
| 173 | 173 | | Administration and in consultation with the Administrator 4 |
|---|
| 174 | 174 | | of the Centers for Medicare & Medicaid Services, shall 5 |
|---|
| 175 | 175 | | award grants or cooperative agreements to States, political 6 |
|---|
| 176 | 176 | | subdivisions of States, and Indian Tribes and Tribal orga-7 |
|---|
| 177 | 177 | | nizations (as such terms are defined in section 4 of the 8 |
|---|
| 178 | 178 | | Indian Self-Determination and Education Assistance Act) 9 |
|---|
| 179 | 179 | | to support the provision of urgent maternal health care 10 |
|---|
| 180 | 180 | | in rural facilities without a dedicated obstetric unit, in-11 |
|---|
| 181 | 181 | | cluding by— 12 |
|---|
| 182 | 182 | | ‘‘(1) supporting the development of statewide or 13 |
|---|
| 183 | 183 | | regional maternal health care telehealth access pro-14 |
|---|
| 184 | 184 | | grams; and 15 |
|---|
| 185 | 185 | | ‘‘(2) supporting the improvement of existing 16 |
|---|
| 186 | 186 | | statewide or regional maternal health care telehealth 17 |
|---|
| 187 | 187 | | access programs described in subsection (b). 18 |
|---|
| 188 | 188 | | ‘‘(b) S |
|---|
| 189 | 189 | | TATEWIDE ORREGIONALMATERNALHEALTH 19 |
|---|
| 190 | 190 | | C |
|---|
| 191 | 191 | | ARETELEHEALTH ACCESSPROGRAMS.—A maternal 20 |
|---|
| 192 | 192 | | health care telehealth access program described in this 21 |
|---|
| 193 | 193 | | section, with respect to which an award under subsection 22 |
|---|
| 194 | 194 | | (a) may be used, shall— 23 |
|---|
| 195 | 195 | | ‘‘(1) be a statewide or regional network of ma-24 |
|---|
| 196 | 196 | | ternal health care teams that provide urgent support 25 |
|---|
| 197 | 197 | | to rural non-obstetric settings of care; 26 |
|---|
| 198 | 198 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 199 | 199 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 8 |
|---|
| 200 | 200 | | •HR 1254 IH |
|---|
| 201 | 201 | | ‘‘(2) support and further develop organized 1 |
|---|
| 202 | 202 | | State or regional networks of maternal health care 2 |
|---|
| 203 | 203 | | teams to provide urgent consultative support to 3 |
|---|
| 204 | 204 | | rural non-obstetric settings of care; 4 |
|---|
| 205 | 205 | | ‘‘(3) conduct an assessment of urgent maternal 5 |
|---|
| 206 | 206 | | health consultation needs among providers in rural 6 |
|---|
| 207 | 207 | | non-obstetric settings of care; 7 |
|---|
| 208 | 208 | | ‘‘(4) provide assurances that the physicians re-8 |
|---|
| 209 | 209 | | sponsive to the teleconsultation line are credentialed 9 |
|---|
| 210 | 210 | | within their employing facility and can provide con-10 |
|---|
| 211 | 211 | | sultation where the patient is receiving care con-11 |
|---|
| 212 | 212 | | sistent with State requirements to provide care to in-12 |
|---|
| 213 | 213 | | dividuals experiencing labor, delivery, obstetric hem-13 |
|---|
| 214 | 214 | | orrhage, severe hypertension in pregnancy and 14 |
|---|
| 215 | 215 | | postpartum, cardiac conditions related to or exacer-15 |
|---|
| 216 | 216 | | bated by pregnancy, perinatal mental health condi-16 |
|---|
| 217 | 217 | | tions, substance use during pregnancy or the 17 |
|---|
| 218 | 218 | | postpartum period, sepsis during pregnancy or after 18 |
|---|
| 219 | 219 | | pregnancy end, or other conditions, as appropriate; 19 |
|---|
| 220 | 220 | | ‘‘(5) provide rapid statewide or regional clinical 20 |
|---|
| 221 | 221 | | telephone or telehealth consultations when requested 21 |
|---|
| 222 | 222 | | between the maternal care teams and providers in 22 |
|---|
| 223 | 223 | | rural emergency non-obstetric settings; and 23 |
|---|
| 224 | 224 | | ‘‘(6) provide information to health care pro-24 |
|---|
| 225 | 225 | | viders about available maternal health services for 25 |
|---|
| 226 | 226 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 227 | 227 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 9 |
|---|
| 228 | 228 | | •HR 1254 IH |
|---|
| 229 | 229 | | people in the community and assist with referrals to 1 |
|---|
| 230 | 230 | | specialty care and community or behavioral health 2 |
|---|
| 231 | 231 | | resources. 3 |
|---|
| 232 | 232 | | ‘‘(c) R |
|---|
| 233 | 233 | | EPORTING.—An entity receiving an award 4 |
|---|
| 234 | 234 | | under this section shall submit a report to the Secretary, 5 |
|---|
| 235 | 235 | | in such manner and containing such information as the 6 |
|---|
| 236 | 236 | | Secretary may require, not later than 18 months after ini-7 |
|---|
| 237 | 237 | | tial receipt of the grant. 8 |
|---|
| 238 | 238 | | ‘‘(d) A |
|---|
| 239 | 239 | | UTHORIZATION OF APPROPRIATIONS.—To 9 |
|---|
| 240 | 240 | | carry out this section, there is authorized to be appro-10 |
|---|
| 241 | 241 | | priated $5,000,000 for the period of fiscal years 2026 11 |
|---|
| 242 | 242 | | through 2029.’’. 12 |
|---|
| 243 | 243 | | SEC. 5. STUDY ON OBSTETRIC UNITS IN RURAL AREAS. 13 |
|---|
| 244 | 244 | | The Secretary of Health and Human Services shall— 14 |
|---|
| 245 | 245 | | (1) conduct a study that maps maternity ward 15 |
|---|
| 246 | 246 | | closures and regional patterns of patient transport 16 |
|---|
| 247 | 247 | | and examines models for regional partnerships for 17 |
|---|
| 248 | 248 | | rural obstetric care; and 18 |
|---|
| 249 | 249 | | (2) not later than 3 years after the date of en-19 |
|---|
| 250 | 250 | | actment of this Act, submit to the Committee on 20 |
|---|
| 251 | 251 | | Health, Education, Labor, and Pensions of the Sen-21 |
|---|
| 252 | 252 | | ate and the Committee on Energy and Commerce 22 |
|---|
| 253 | 253 | | and the Committee on Education and Workforce of 23 |
|---|
| 254 | 254 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1254.IH H1254 |
|---|
| 255 | 255 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 10 |
|---|
| 256 | 256 | | •HR 1254 IH |
|---|
| 257 | 257 | | the House of Representatives, a report on the results 1 |
|---|
| 258 | 258 | | of the study conducted under paragraph (1). 2 |
|---|
| 259 | 259 | | Æ |
|---|
| 260 | 260 | | VerDate Sep 11 2014 22:24 Mar 10, 2025 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\H1254.IH H1254 |
|---|
| 261 | 261 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB |
|---|