Urban Indian Health Providers Facilities Improvement Act

Mr. president. There are significant racial and ethnic inequities in maternal and infant mortality rates in the U.S. American Indian/Alaska Native women are more than twice as likely as nonHispanic white women to die as a result of pregnancy or its complications, and the infant mortality rate among babies born to American Indian/Alaska Native women is 2.1 times higher than that of non-Hispanic white women. According to the Centers for Disease Control and Prevention, the maternal mortality rate for non-Hispanic Black women in 2018 is more than 2.5 times higher than the maternal mortality rate of non-Hispanic white women, and the infant mortality rate of non-Hispanic Black women is more than 2.3 times higher than the infant mortality rate of non- Hispanic white women. Any pregnant woman choosing to have a child should be able to do so safely without regard to income, race, ethnicity, employment status, or any other socio-economic factor.

This is why Senator Murkowski and I are reintroducing the Mothers and Newborns Success Act, which aims to reduce maternal and infant mortality, ensure that all infants can grow up healthy and safe, and protect women's health before, during, and after pregnancy. Our legislation supports innovation in maternal health delivery and improves data collection on maternal mortality and maternal deaths, including implementing quality assurance processes to improve the validity of pregnancy checkbox data from death certificates so that we can better understand the causes of maternal deaths. The bill will help ensure that women are matched with birthing facilities that are risk- appropriate for their particular needs to improve maternal and neonatal care and health outcomes. The legislation strengthens support for women during the critical postpartum period, the year after birth.

The bill also establishes a public and provider awareness campaign through the Centers for Disease Control and Prevention to promote awareness of maternal health warnings signs and the importance of vaccinations for pregnant women and children, ensuring pregnant women get the vaccinations they need. The bill promotes maternal health research, providing technical assistance to states to ensure representation of communities of color in key datasets. The bill establishes a National Maternal Health Research Network at the National Institute of Health to support innovative research to reduce maternal mortality and promote maternal health. The bill supports the Rural Maternity and Obstetric Management Strategies (RMOMS) Program at the Health Resources and Services Administration to improve access to, and continuity of, obstetrics care in rural communities, including thorough use of telehealth.

No woman should fear for her or her child's health because of socio- economic factors, such as race or geographic location. We need to ensure more women of color and their children, particularly Black women and children given the significant disparities they experience, receive equitable care and a fair chance for a healthy pregnancy and safe delivery. COVID-19 and its impact on pregnant women has only underscored the need for urgent action. The Mothers and Newborns Success Act is a significant step toward reducing racial, ethnic, and geographic inequities in maternal and infant health. I'm calling on my Senate colleagues to cosponsor this bill and support its passage so we can enact positive systemic changes to make sure more women and newborns thrive and have the maximum chance for success.

Mr. President, I rise to introduce the bipartisan ``Urban Indian Health Providers Facilities Improvement Act.''

This legislation honors our Federal trust responsibility by providing parity to Urban Indian Organizations that provide culturally competent health care to Native Americans living in urban areas.

This legislation would remove the unjust and arbitrary restriction that prevents Urban Indian Organizations from using appropriated funds for construction and facilities upgrades.

This restriction is particularly untenable in the midst of the COVID- 19 pandemic.

Current law only permits the Indian Health Service to make construction or facilities funds available to Urban Indian Organizations to assist them in meeting or maintaining a now-obsolete accreditation standard.

This limitation prevents Urban Indian Organizations from using appropriated funding for facilities, maintenance and improvement, sanitation, equipment, and other necessary construction upgrades, which limits their ability to provide the quality health care that Native Americans deserve.

Urban Indian Organizations are the only tribal health organization burdened by this restriction. This legislation would provide parity to Urban Indian Organizations and improve the safety and quality of care for urban Indians.

California is home to one of the largest populations of Native Americans, and Los Angeles and San Francisco have two of the largest urban Native American populations in the country. Almost 90% of Native Americans in California live in urban areas and therefore don't access health care through their tribe.

Further, there are no Indian Health Service hospitals in California, so the California Urban Indian Organizations are a lifeline to Native Americans in my state. Removing this unjust burden on Urban Indian Organizations would allow them to improve the quality of the culturally competent care that they provide.

I thank Senator Lankford for co-leading this bill with me, and Congressmen Gallego and Bacon for introducing this legislation in the House of Representatives.

I look forward to working with my colleagues to pass the bipartisan ``Urban Indian Health Providers Facilities Improvement Act'' as quickly as possible.

Thank you, Mr. President. I yield the floor.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.