HR5406-119

2. Grants for demonstration projects to provide career pathways in the field of pregnancy, childbirth, or post-partum Section 2008 of the Social Security Act (42 U.S.C. 1397g) is amended by redesignating subsection (d) as subsection (e) and inserting after subsection (c) the following: The Secretary, in consultation with the Secretary of Labor and the Secretary of Education, shall award grants in accordance with this subsection to eligible entities to conduct demonstration projects for the purpose of providing education and training for eligible individuals to enter and follow a career pathway in the field of pregnancy, childbirth, or postpartum, in a State that recognizes doulas or midwives and that provides payment for services provided by doulas or midwives, as the case may be, under private or public health insurance plans. A demonstration project shall be conducted under this subsection for not less than 3 years. An applicant seeking a grant under this subsection for a demonstration project shall submit to the Secretary an application for the grant, that includes the following: A description of the partnerships, strategic staff hiring decisions, tailored program activities, or other programmatic elements of the project that are designed to support a strong career pathway in pregnancy, birth, or postpartum services. A demonstration that the State in which the project is to be conducted recognizes and permits doulas and midwives to practice in the State. A demonstration that the applicant has experience working with low-income populations, or a description of the plan of the applicant to work with a partner that has the experience. The Secretary shall, by grant, contract, or interagency agreement, conduct rigorous and well-designed evaluations of the demonstration projects for which a grant is made under this section, which shall include identification of successful activities for creating opportunities for developing and sustaining, particularly with respect to low-income individuals and other entry-level workers, a doula, midwife, or other pregnancy or postpartum workforce career pathway that has accessible entry points, that meets high standards for education, training, certification, and professional development, and that provides increased wages and affordable benefits, including health care coverage, that are responsive to the needs of the workforce. In this subsection: The term eligible entity means any of the following entities that demonstrates in an application submitted under this subsection that the entity has the capacity to fully develop and administer the demonstration project described in the application: A local workforce development board established under section 107 of the Workforce Innovation and Opportunity Act. A State or territory, a political subdivision of a State or territory, or an agency of a State, territory, or such a political subdivision. An Indian tribe, a tribal organization, or a tribal college or university. An institution of higher education (as defined in the Higher Education Act of 1965). A hospital (as defined in section 1861(e)). A skilled nursing facility (as defined in section 1819(h)(1)(A)). A Federally qualified health center (as defined in section 1861(aa)(4)). A nonprofit organization described in section 501(c)(3) of the Internal Revenue Code of 1986, a labor organization, or an entity with shared labor-management oversight, that has a demonstrated history of providing health profession training to eligible individuals. An entity recognized by a State, Indian tribe, or tribal organization as qualified to train doulas or midwives, if midwives or doulas, as the case may be, are permitted to provide services in the State involved. An opioid treatment program (as defined in section 1861(iii)(2)) and other high quality comprehensive addiction care providers. The term eligible individual means an individual whose income does not exceed 138 percent of the Federal poverty level. The term midwife means a midwife who meets, at a minimum, the international definition of the midwife and global standards for midwifery education as established by the International Confederation of Midwives. The term tribally-recognized midwife means an individual who is recognized by an Indian tribe (as defined in section 4 of the Indian Health Care Improvement Act) to practice midwifery for the tribe. The term doula means, with respect to an application to conduct a demonstration project under this subsection, an individual who— has completed 60 hours of training in providing non-medical information, emotional support, and physical support to clients during pregnancy, childbirth, and the postpartum period; is certified by an organization, that has been established for not less than 5 years and requires the completion of continuing education to maintain the certification, to provide the information and support referred to in subclause (I); and maintains the certification by completing the required continuing education; or has the permission of the local government in the State in which the applicant intends to conduct the demonstration project, to provide the information and support referred to in clause (i)(I). Out of any funds in the Treasury of the United States not otherwise appropriated, there are appropriated to the Secretary to carry out this subsection $10,000,000 for fiscal year 2026. (d) Demonstration projects To provide career pathways in the field of pregnancy, childbirth, or postpartum (1) Grant authority The Secretary, in consultation with the Secretary of Labor and the Secretary of Education, shall award grants in accordance with this subsection to eligible entities to conduct demonstration projects for the purpose of providing education and training for eligible individuals to enter and follow a career pathway in the field of pregnancy, childbirth, or postpartum, in a State that recognizes doulas or midwives and that provides payment for services provided by doulas or midwives, as the case may be, under private or public health insurance plans. (2) Duration A demonstration project shall be conducted under this subsection for not less than 3 years. (3) Application requirements An applicant seeking a grant under this subsection for a demonstration project shall submit to the Secretary an application for the grant, that includes the following: (A) A description of the partnerships, strategic staff hiring decisions, tailored program activities, or other programmatic elements of the project that are designed to support a strong career pathway in pregnancy, birth, or postpartum services. (B) A demonstration that the State in which the project is to be conducted recognizes and permits doulas and midwives to practice in the State. (C) A demonstration that the applicant has experience working with low-income populations, or a description of the plan of the applicant to work with a partner that has the experience. (4) Evaluations The Secretary shall, by grant, contract, or interagency agreement, conduct rigorous and well-designed evaluations of the demonstration projects for which a grant is made under this section, which shall include identification of successful activities for creating opportunities for developing and sustaining, particularly with respect to low-income individuals and other entry-level workers, a doula, midwife, or other pregnancy or postpartum workforce career pathway that has accessible entry points, that meets high standards for education, training, certification, and professional development, and that provides increased wages and affordable benefits, including health care coverage, that are responsive to the needs of the workforce. (5) Definitions In this subsection: (A) Eligible entity The term eligible entity means any of the following entities that demonstrates in an application submitted under this subsection that the entity has the capacity to fully develop and administer the demonstration project described in the application: (i) A local workforce development board established under section 107 of the Workforce Innovation and Opportunity Act. (ii) A State or territory, a political subdivision of a State or territory, or an agency of a State, territory, or such a political subdivision. (iii) An Indian tribe, a tribal organization, or a tribal college or university. (iv) An institution of higher education (as defined in the Higher Education Act of 1965). (v) A hospital (as defined in section 1861(e)). (vi) A skilled nursing facility (as defined in section 1819(h)(1)(A)). (vii) A Federally qualified health center (as defined in section 1861(aa)(4)). (viii) A nonprofit organization described in section 501(c)(3) of the Internal Revenue Code of 1986, a labor organization, or an entity with shared labor-management oversight, that has a demonstrated history of providing health profession training to eligible individuals. (ix) An entity recognized by a State, Indian tribe, or tribal organization as qualified to train doulas or midwives, if midwives or doulas, as the case may be, are permitted to provide services in the State involved. (x) An opioid treatment program (as defined in section 1861(iii)(2)) and other high quality comprehensive addiction care providers. (B) Eligible individual The term eligible individual means an individual whose income does not exceed 138 percent of the Federal poverty level. (C) Midwife The term midwife means a midwife who meets, at a minimum, the international definition of the midwife and global standards for midwifery education as established by the International Confederation of Midwives. (D) Tribally-recognized midwife The term tribally-recognized midwife means an individual who is recognized by an Indian tribe (as defined in section 4 of the Indian Health Care Improvement Act) to practice midwifery for the tribe. (E) Doula The term doula means, with respect to an application to conduct a demonstration project under this subsection, an individual who— (i) (I) has completed 60 hours of training in providing non-medical information, emotional support, and physical support to clients during pregnancy, childbirth, and the postpartum period; (II) is certified by an organization, that has been established for not less than 5 years and requires the completion of continuing education to maintain the certification, to provide the information and support referred to in subclause (I); and (III) maintains the certification by completing the required continuing education; or (ii) has the permission of the local government in the State in which the applicant intends to conduct the demonstration project, to provide the information and support referred to in clause (i)(I). (6) Appropriation Out of any funds in the Treasury of the United States not otherwise appropriated, there are appropriated to the Secretary to carry out this subsection $10,000,000 for fiscal year 2026. .