H.R. 8089 — Perinatal Workforce Act

This section directs the Secretary of Health and Human Services (HHS), not later than two years after enactment, to (1) issue guidance to states educating providers, managed care entities, and insurers on delivering respectful maternal health care through diverse multidisciplinary models—including recruitment of diverse maternity care providers trained on implicit bias, incorporation of midwives and other team members, collaborative culturally congruent care, and midwifery job shadowing opportunities; and (2) conduct a study through the NIH Director on best practices in respectful and culturally and linguistically congruent maternity care, with a report to Congress that includes compendiums of exemplary providers and insurers and recommendations to reduce maternal health disparities.

This section establishes a grant program under Title VII of the Public Health Service Act to grow and diversify the perinatal workforce. Grant recipients must use funds to establish or expand accredited schools or programs training physician assistants for clinical work in maternal and perinatal health, perinatal health workers, or midwives meeting International Confederation of Midwives standards; or to increase enrollment capacity in such programs (e.g., via scholarships for racially, ethnically, and linguistically diverse students). In awarding grants (up to five years), the Secretary must prioritize applicants with strategies to recruit and retain diverse students and faculty (especially racial and ethnic minorities and underserved populations), students committing to health professional shortage areas or maternal health disparity areas, and curricula including bias, racism, and discrimination training (covering implicit and explicit bias). Recipients must submit annual reports on student demographics and career placements, and the Secretary must issue a report to Congress after four years evaluating program effectiveness in increasing diverse perinatal professionals in shortage and disparity areas. The section authorizes $15 million annually for FY2027 through FY2031.

This section establishes the Perinatal Nursing Workforce Grants program under Title VIII of the Public Health Service Act. Under the program, the Secretary of Health and Human Services awards grants to schools of nursing to provide scholarships to students seeking to become (1) nurse practitioners whose education includes a focus on maternal and perinatal health, (2) certified nurse-midwives, or (3) clinical nurse specialists whose education includes a focus on maternal and perinatal health. In awarding grants, the Secretary prioritizes schools of nursing that (1) recruit and retain diverse students (particularly from racial and ethnic minority groups and other underserved populations) for maternal and perinatal health careers, (2) partner with practice settings in health professional shortage areas (HPSAs) under section 332 for student clinical placements, (3) recruit and retain students planning to practice in areas with significant racial and ethnic maternal health disparities (to the extent practicable), and (4) include bias, racism, or discrimination training (with education on implicit bias and racism) in the standard curriculum for such students. Grant recipients must submit annual reports to the Secretary on student numbers and demographics, career placements in HPSAs and maternal health disparity areas, and curriculum elements; grants are for up to 5 years; the Secretary must provide technical assistance; and not later than 4 years after enactment, the Secretary must report to Congress on the program's effectiveness in diversifying and deploying the perinatal nursing workforce (including in HPSAs and disparity areas). The section authorizes $15 million for each of FY2027 through FY2031.

This section directs the Comptroller General of the United States to submit to Congress, not later than two years after the date of enactment and every five years thereafter, a report on barriers to maternal health education and access to care in the United States. The report must include (1) an assessment of barriers to entering and completing accredited midwifery education programs, with recommendations, particularly for low-income women and women from racial and ethnic minority groups; (2) a similar assessment for accredited education programs for maternity care providers, mental and behavioral health care providers acting in accordance with state law, and registered dietitians or nutrition professionals (as defined in section 1861(vv)(2) of the Social Security Act (42 U.S.C. 1395x(vv)(2))); (3) an assessment of barriers preventing midwives from meeting the international definition of a midwife and global standards for midwifery education established by the International Confederation of Midwives, with recommendations, particularly for low-income women and women from racial and ethnic minority groups; (4) an assessment of disparities in access to maternity care providers, mental or behavioral health care providers acting in accordance with state law, registered dietitians or nutrition professionals, and perinatal health workers, stratified by race, ethnicity, gender identity, primary language, geographic location, and insurance type, with recommendations to promote greater access equity; and (5) recommendations to promote greater equity in compensation for perinatal health workers under public and private insurers, particularly for such individuals from racially and ethnically diverse backgrounds.

This section defines terms for purposes of the Act, including: (1) culturally and linguistically congruent, meaning care that aligns with the preferred cultural values, beliefs, worldview, language, and practices of the health care consumer and other stakeholders; (2) maternity care provider, meaning a physician, physician assistant, midwife meeting International Confederation of Midwives standards, advanced practice registered nurse, State-accredited doula eligible for Medicaid reimbursement, or International Board of Lactation Consultant Examiners-certified lactation consultant with a focus on maternal or perinatal health; (3) perinatal health worker, meaning a nonclinical worker focused on maternal or perinatal health (e.g., 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, meaning the one-year period beginning on the last day of pregnancy; and (5) racial and ethnic minority group, having the meaning given in section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u-6(g)(1)).