Bill Text: IL SB1826 | 2021-2022 | 102nd General Assembly | Introduced

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Bill Title: Creates the Consumer Choice in Maternal Care for African-American Mothers Pilot Program Act. Requires the Task Force on Infant and Maternal Mortality Among African Americans to partner with community-based maternal care providers to develop rules and regulations for a Medicaid voucher pilot program to expand consumer choice for Black mothers that includes planned home birth services and in-home perinatal and postpartum care services provided by racially concordant nationally accredited certified professional midwives. Requires the Department of Healthcare and Family Services to implement the pilot program no later than January 1, 2023. Provides that the pilot program shall operate for a 5-year period. Requires the Task Force to submit annual reports to the General Assembly, beginning January 1, 2024, and each January 1 thereafter through January 1, 2028, that provides a status update on the pilot program and annual impact measure reporting. Provides that the pilot program shall implement a maternity episode payment model that provides a single payment for all services across the prenatal, intrapartum, and postnatal period which covers the 9 months of pregnancy plus 12 weeks of postpartum. Requires the Department of Healthcare and Family Services to make available to the Task Force all relevant data related to maternal care expenditures made under the State's Medical Assistance Program so that budget-neutral reimbursement rates can be established for bundled maternal care services spanning the prenatal, labor and delivery, and postpartum phases of a maternity episode.

Spectrum: Partisan Bill (Democrat 11-0)

Status: (Introduced - Dead) 2021-05-19 - Added as Co-Sponsor Sen. Mike Simmons [SB1826 Detail]

Download: Illinois-2021-SB1826-Introduced.html

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102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 SB1826 Introduced 2/26/2021, by Sen. Patricia Van Pelt SYNOPSIS AS INTRODUCED:
New Act
Creates the Consumer Choice in Maternal Care for African-American Mothers Pilot Program Act. Requires the Task Force on Infant and Maternal Mortality Among African Americans to partner with community-based maternal care providers to develop rules and regulations for a Medicaid voucher pilot program to expand consumer choice for Black mothers that includes planned home birth services and in-home perinatal and postpartum care services provided by racially concordant nationally accredited certified professional midwives. Requires the Department of Healthcare and Family Services to implement the pilot program no later than January 1, 2023. Provides that the pilot program shall operate for a 5-year period. Requires the Task Force to submit annual reports to the General Assembly, beginning January 1, 2024, and each January 1 thereafter through January 1, 2028, that provides a status update on the pilot program and annual impact measure reporting. Provides that the pilot program shall implement a maternity episode payment model that provides a single payment for all services across the prenatal, intrapartum, and postnatal period which covers the 9 months of pregnancy plus 12 weeks of postpartum. Requires the Department of Healthcare and Family Services to make available to the Task Force all relevant data related to maternal care expenditures made under the State's Medical Assistance Program so that budget-neutral reimbursement rates can be established for bundled maternal care services spanning the prenatal, labor and delivery, and postpartum phases of a maternity episode.
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FISCAL NOTE ACT MAY APPLY
A BILL FOR
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AN ACT concerning maternal health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the
Consumer Choice in Maternal Care for African-American Mothers
Pilot Program Act.
Section 5. Findings. The General Assembly finds the
following:
(1) In its 2018 Illinois Maternal Morbidity and
Mortality Report, the Department of Public Health reported
that Black women were 6 times as likely to die from a
pregnancy-related condition as white women; and that in
Illinois, 72% of pregnancy-related deaths and 93% of
violent pregnancy-associated deaths were deemed
preventable.
(2) The Department of Public Health also found that
between 2016 and 2017, Black women had the highest rate of
severe maternal morbidity with a rate of 101.5 per 10,000
deliveries, which is almost 3 times as high as the rate for
white women.
(3) In 2019, the Chicago Department of Public Health
released a data report on Maternal Morbidity and Mortality
in Chicago and found that "(w]omen for whom Medicaid was

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the delivery payment source are significantly more likely
than those who used private insurance to experience severe
maternal morbidity." The Chicago Department of Public
Health identified zip codes within the city that had the
highest rates of severe maternal morbidity in 2016-2017
(100.4-172.8 per 10,000 deliveries). These zip codes
included: 60653, 60637, 60649, 60621, 60612, 60624, and
60644. All of the zip codes were identified as
experiencing high economic hardship. According to the
Chicago Department of Public Health "(c)hronic diseases,
including obesity, hypertension, and diabetes can increase
the risk of a woman experiencing adverse outcomes during
pregnancy." However, "there were no significant
differences in pre-pregnancy BMI, hypertension, and
diabetes between women who experienced a
pregnancy-associated death and all women who delivered
babies in Chicago."
(4) In a national representative survey sample of
mothers who gave birth in an American hospital in
2011-2012, 1 out of 4 mothers who identified as Black or
African-American expressed that they would "definitely
want" to have a future birth at home, compared to 8.4% of
white mothers. Black mothers express a demand for planned
home birth services at almost 3 times the rate of white
mothers. And yet, in the United States, non-Hispanic white
women who can afford to pay out-of-pocket for their labor

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and delivery costs access planned home birth care at the
greatest rate. Similarly, an analysis of birth certificate
data from the Centers for Disease Control and Prevention
for the years 2016-2019 shows that non-Hispanic white
mothers are 7 times more likely than non-Hispanic Black
mothers to experience a planned home birth.
(5) According to calculations based on birth
certificate data from July 2019 in Cook County, there
would have to be 7 Black or African-American certified
professional midwives working in Cook County in order for
just 1% of Black mothers in Cook County to have access to
racially concordant midwifery care in a given month.
(6) For birthing persons of sufficient health who
desire to give birth outside of an institutional setting
without the assistance of epidural analgesia, planned home
birth under the care of a certified professional midwife
can be a dignifying and safe, evidence-based choice. In
contrast, regulatory impingement on Black families'
ability to access that choice does not serve to enhance
maternal or neonatal safety, but instead reifies the
institutionalization of Black bodies by the State.
(7) In order to make safe, planned home births
accessible to Black families in Illinois, the State must
require Medicaid provider networks to include certified
professional midwives. According to natality data from the
Centers for Disease Control and Prevention, every year

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from 2016 through 2019, 2 out of every 3 live births to
Black or African-American mothers living in Cook County
utilized Medicaid as the source of payment for delivery.
According to that same data, Medicaid paid for over 14,000
deliveries to Black or African-American mothers residing
in Cook County during the year 2019 alone.
(8) A population-level, retrospective cohort study
published in 2018 that used province-wide maternity,
medical billing, and demographic data from British
Columbia, Canada concluded that antenatal midwifery care
in British Columbia was associated with lower odds of
small-for-gestational-age birth, preterm birth, and low
birth weight for women of low socioeconomic position
compared with physician models of care. Results support
the development of policy to ensure antenatal midwifery
care is available and accessible for women of low
socioeconomic position.
(9) In its January 2018 report to the General
Assembly, the Department of Healthcare and Family Services
reported that its infant and maternal care expenditures in
calendar year 2015 totaled $1,410,000,000. The Department
of Healthcare and Family Services said, "(t)he majority of
HFS birth costs are for births with poor outcomes. Costs
for Medicaid covered births are increasing annually while
the number of covered births is decreasing for the same
period." The Department of Healthcare and Family Services'

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expenditures average $12,000/birth during calendar year
2015 for births that did not involve poor outcomes such as
low birth weight, very low birth weight, and infant
mortality. That $12,000 expenditure covered prenatal,
intrapartum, and postpartum maternal healthcare, as well
as infant care through the first year of life. The next
least expensive category of births averaged an expenditure
of $40,200. The most expensive category of births refers
to births resulting in very low birth weight which cost
the Department of Healthcare and Family Services over
$328,000 per birth.
(10) Expanding Medicaid coverage to include perinatal
and intrapartum care by certified professional midwives
will not contribute to increased taxpayer burden and, in
fact, will likely decrease the Department of Healthcare
and Family Services' expenditures on maternal care while
improving maternal health outcomes within the Black
community in Illinois.
Section 10. Medicaid voucher pilot program. The Task
Force on Infant and Maternal Mortality Among African Americans
shall partner with community-based maternal care providers to
develop rules and regulations for a Medicaid voucher pilot
program to expand consumer choice for Black mothers that
includes planned home birth services and in-home perinatal and
postpartum care services provided by racially concordant

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nationally accredited certified professional midwives. The
Department of Healthcare and Family Services shall implement
the pilot program no later than January 1, 2023 and the pilot
program shall operate for a 5-year period. On January 1, 2024,
and each January 1 thereafter through January 1, 2028, the
Task Force shall submit a report to the General Assembly that
provides a status update on the pilot program and annual
impact measure reporting.
Section 15. Maternity episode payment model. The pilot
program shall implement a maternity episode payment model that
provides a single payment for all services across the
prenatal, intrapartum, and postnatal period which covers the 9
months of pregnancy plus 12 weeks of postpartum. The core
elements of the maternity care episode payment model shall
include all of the following:
(1) Limited exclusion of selected high-cost health
conditions and further adjustments to limit service
provider risk such as risk adjustment and stop loss.
(2) Duration from the initial entry into prenatal care
through the postpartum and newborn periods.
(3) Single payment for all services across the
episode.
The Department of Healthcare and Family Services shall
make available to the Task Force all relevant data related to
maternal care expenditures made under the State's Medical

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Assistance Program so that budget-neutral reimbursement rates
can be established for bundled maternal care services spanning
the prenatal, labor and delivery, and postpartum phases of a
maternity episode.