LegiStorm

Summary:

The Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (HHS) is one of the federal agencies charged with addressing U.S. maternal health outcomes. HRSA's Improving Maternal Health in America initiative aims to address U.S. maternal health issues by, among other approaches, improving maternal health data, increasing maternal health research, and prioritizing quality improvement in maternal health care services. The FY2019 appropriations report language for the Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019, and Continuing Appropriations Act, 2019 (P.L. 115-245), reserved $26 million within the Special Projects for Regional and National Significance (SPRANS) program for, among other things, the Alliance for Innovation on Maternal Health (AIM) program and the establishment of new maternal health programs under HRSA. Using the SPRANS authority, HRSA established four new maternal health programs designed to improve maternal health outcomes and to prevent and reduce U.S. cases of maternal mortality and severe maternal morbidity (SMM). SMM refers to medical conditions that adversely affect the maternal health care outcome of labor and delivery, resulting in either short-term or long-term consequences for pregnant and postpartum women. For FY2019, HRSA made awards under each of the four programs, via cooperative agreements, in which HRSA provided financial assistance to the recipients and is involved in program activities. The recipients of awards made under the previously existing AIM program and each of the four new maternal health programs must collaborate with each other. Previously Existing Maternal Health Program: Alliance for Innovation on Maternal Health (AIM). This five-year maternal health program funds a single project that promotes the adoption and implementation of hospital-focused maternal safety bundles (evidence-based practices) for health care providers in birthing facilities and hospitals. Maternal Health Program 1: Alliance for Innovation on Maternal Health (AIM–Community Care Initiative). This five-year maternal health program funds a single project that expands upon the work of the initial AIM program. The program award recipient supports the development, adoption, and implementation of nonhospital maternal safety bundles for health care providers in community-based organizations and outpatient settings. Maternal Health Program 2: Rural Maternity and Obstetrics Management Strategies (RMOMS) Program. This four-year maternal health pilot program funds the development, testing, and implementation of service models, with the goal of improving access to, and continuity of, maternal and obstetrics care in rural communities. Program award recipients create strategies to address each of the following four RMOMS focus areas: (1) rural hospital obstetric service aggregation, (2) network approach to coordinating a continuum of care, (3) leveraging telehealth and specialty care, and (4) financial sustainability. Maternal Health Program 3: State Maternal Health Innovation (MHI) Program. This five-year maternal health program funds state-focused demonstration projects, with the goal of improving U.S. maternal health outcomes. State-focused demonstration projects undertake three core functions: (1) establishing a state-focused Maternal Health Task Force, (2) improving state-level maternal health data and surveillance, and (3) promoting and implementing innovations in the health care delivery of maternal health care services. Maternal Health Program 4: Supporting Maternal Health Innovation (MHI) Program. This five-year maternal health program aims to support states, key stakeholders, and recipients of HRSA-administered awards, with the goal of reducing and preventing U.S. cases of SMM and maternal mortality, and improving U.S. maternal health outcomes. For example, the Supporting MHI program provides capacity-building assistance to the state-focused demonstration projects under the State MHI program and to RMOMS program recipients. In addition, the Supporting MHI program is expected to establish a national resource center designed to help the AIM–Community Care Initiative recipient determine whether any of the nonhospital maternal safety bundles are evidence-informed and could reduce U.S. SMM and maternal mortality. To assist Congress as it considers measures on U.S. maternal health, this report provides an overview and the funding history of the five maternal health programs that HRSA administers. For each of the five maternal health programs, the report provides an overview of the program, discusses the main core activities and functions of the program, provides the program's criteria of eligibility and reporting requirements, and discusses the program's funding allocations.