Momnibus Act

(a) In general. The Secretary of Health and Human Services (referred to in this section as the Secretary) shall, in coordination with entities described in subsection (b)—

(1) not later than 90 days after the enactment of this Act, enter into a 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 or childbirth outcomes in the populations of American Indian and Alaska Native individuals; and

(2) not later than 3 years after the date of the enactment of this Act, submit to Congress a report on such study that contains recommendations for policies and practices that can be adopted to improve maternal health outcomes for American Indian and Alaska Native individuals.

(b) Participating entities. The entities described in this subsection shall consist of 12 members, selected by the Secretary from among individuals nominated by Indian Tribes and Tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304)), and Urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)). In selecting such members, the Secretary shall ensure that each of the 12 service areas of the Indian Health Service is represented.

(c) Contents of study. The study conducted pursuant to subsection (a) shall—

(1) examine the causes of maternal mortality and severe maternal morbidity that are unique to American Indian and Alaska Native individuals;

(2) include a systematic process of listening to the stories of American Indian and Alaska Native individuals to fully understand the causes of, and inform potential solutions to, the maternal health crisis within their respective communities;

(3) distinguish between the causes of, landscape of maternity care at, and recommendations to improve maternal health outcomes within, the different settings in which American Indian and Alaska Native individuals receive maternity care, such as—

(A) facilities operated by the Indian Health Service;

(B) an Indian health program operated by an Indian Tribe or Tribal organization pursuant to a contract, grant, cooperative agreement, or compact with the Indian Health Service pursuant to the Indian Self-Determination Act;

(C) an urban Indian health program operated by an Urban Indian organization pursuant to a grant or contract with the Indian Health Service pursuant to title V of the Indian Health Care Improvement Act; and

(D) facilities outside of the Indian Health Service in which American Indian and Alaska Native individuals receive maternity care services;

(4) review processes for coordinating programs of the Indian Health Service with social services provided through other programs administered by the Secretary of Health and Human Services (other than the Medicare Program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)), the Medicaid Program under title XIX of such Act (42 U.S.C. 1396 et seq.), and the Children’s Health Insurance Program under title XXI of such Act (42 U.S.C. 1397 et seq.);

(5) review current data collection and quality measurement processes and practices;

(6) assess causes and frequency of maternal mental health conditions and substance use disorders;

(7) consider social determinants of health, including poverty, lack of health insurance, unemployment, sexual and domestic violence, and environmental conditions in Tribal areas;

(8) consider the role that historical mistreatment of American Indian and Alaska Native women has played in causing currently elevated rates of maternal mortality, severe maternal morbidity, and other adverse perinatal or childbirth outcomes;

(9) consider how current funding of the Indian Health Service affects the ability of the Service to deliver quality maternity care;

(10) consider the extent to which the delivery of maternity care services is culturally appropriate for American Indian and Alaska Native individuals;

(11) make recommendations to reduce misclassification of American Indian and Alaska Native individuals, including consideration of best practices in training for maternal mortality review committee members to be able to correctly classify American Indian and Alaska Native individuals; and

(12) make recommendations informed by the stories shared by American Indian and Alaska Native individuals referred to in paragraph (2) to improve maternal health outcomes for such individuals.

(d) Report. The agreement entered into under subsection (a) with an independent research organization or Tribal Epidemiology Center shall require that the organization or Center transmit to Congress a report on the results of the study conducted pursuant to that agreement not later than 36 months after the date of the enactment of this Act.

(e) Authorization of appropriations. There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2027 through 2029.