Bill
S 4186
The bill creates grants, guidance, and a study to grow a diverse, culturally congruent perinatal workforce and improve maternal care in underserved communities.
Purpose
- The bill aims to grow and diversify the perinatal workforce and advance respectful, culturally and linguistically congruent maternity care. It would create new grant programs, guidance for states, and a federal study to reduce disparities and improve maternal health outcomes.
Key Provisions
1) HHS Guidance to States
- Timing: Within 2 years of enactment.
- Content: Guidance to educate providers, managed care entities, and insurers about delivering respectful maternal health care through diverse, multidisciplinary care teams.
- Goals for States include:
- Recruiting and retaining maternity care providers and related professionals (mental health providers, registered dietitians) from racially, ethnically, and linguistically diverse backgrounds.
- Incorporating multidisciplinary maternity care teams that include midwives meeting international standards, perinatal health workers, physician assistants, advanced practice registered nurses, and certified lactation consultants.
- Providing culturally and linguistically congruent care.
- Creating opportunities for students enrolled in accredited midwifery education to shadow on-the-job with maternity care teams.
2) NIH-Directed Study on Respectful, Culturally Congruent Care
- A study on best practices for respectful and culturally/linguistically congruent maternity care.
- Deliverables (due within 2 years of enactment):
- A public report with exemplars of entities delivering respectful care.
- Examples of entities making progress on reducing disparities and improving birth experiences for pregnant/postpartum individuals from minority groups.
- Recommendations for best practices across hospitals, health systems, midwifery practices, birth centers, and insurers.
3) Perinatal Workforce Grants (Title VII Augmentation)
- New program: Section 758 of the Public Health Service Act.
- Purpose: Award grants to establish or expand programs to grow and diversify the perinatal workforce.
- Uses of Funds:
- Establish/accredit schools or programs for licensing/certification of:
- Physician assistants with maternal/perinatal health focus.
- Perinatal health workers.
- Midwives meeting international standards.
- Expand capacity of existing accredited programs, including scholarships targeting students from diverse backgrounds.
- Prioritization Criteria:
- Commitment to recruiting/retaining minority students and faculty.
- Strategies to recruit/retain diverse student populations, including underserved groups.
- Plans to serve health professional shortage areas and areas with maternal health disparities.
- Inclusion of bias/anti-racism training in curricula.
- Reporting: Grantees must submit annual reports on student demographics, career placement in shortage areas or high-disparity regions, and training effectiveness.
- Grant Term: Up to 5 years.
- Authorized Appropriations: $15 million annually for FY2027–FY2031.
4) Perinatal Nursing Workforce Grants (Title VIII Expansion)
- New program: Section 812 of the Public Health Service Act.
- Purpose: Awards to schools of nursing to grow/diversify the perinatal nursing workforce.
- Uses of Funds:
- Scholarships for students pursuing maternal/perinatal health-focused roles (e.g., nurse practitioners with maternal health focus, certified nurse-midwives, clinical nurse specialists with maternal health focus).
- Prioritization Criteria:
- Recruiting/retaining diverse students.
- Partnerships with practice settings in health professional shortage areas.
- Plans to serve areas with maternal health disparities.
- Inclusion of bias/anti-racism training in curricula.
- Reporting and grant terms mirror the provisions for the perinatal workforce grants.
- Authorized Appropriations: $15 million annually for FY2027–FY2031.
5) GAO Reporting Requirement
- Timing: First report within 2 years post-enactment, then every 5 years.
- Focus: Barriers to maternal health education and access to care; recommendations to address barriers, especially for low-income and minority groups; disparities in access and compensation.
Definitions
- Clarifies terms for culturally and linguistically congruent care, maternity care providers (including physicians, PAs, midwives, advanced practice nurses, doulas, lactation consultants), perinatal health workers, postpartum period, and racial/ethnic minority group.
Impact and Reach
- Targets expansion of a more diverse, multidisciplinary perinatal workforce.
- Aims to improve access to culturally competent care in underserved communities.
- Establishes federally funded grants, state guidance, and evaluative reporting to track progress and inform future policy.
Compiled from official sources — confirm details with the bill’s official record.
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