"Community-led Birthing Justice and Equity Resource Initiative Program Act;" appropriates $12 million.

A4843

ASSEMBLY, No. 4843

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED MAY 4, 2026

Sponsored by:

Assemblywoman� SHANIQUE SPEIGHT

District 29 (Essex and Hudson)

Assemblywoman� VERLINA REYNOLDS-JACKSON

District 15 (Hunterdon and Mercer)

Assemblywoman� LINDA S. CARTER

District 22 (Somerset and Union)

Co-Sponsored by:

Assemblyman Onyema

SYNOPSIS

���� �Community-led Birthing Justice and Equity Resource
Initiative Program Act;� appropriates $12 million.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act

concerning black maternal and infant health,
supplementing Title 26 of the Revised Statutes, and making an appropriation.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.� This act shall be known
and may be cited as the �Community-led Birthing Justice and Equity Resource
Initiative Program Act.�

���� 2.� The Legislature finds and
declares that:

���� a.� The United States has the
highest maternal mortality rate of any high-income country, more than doubling
between 1999 and 2019, with Black women experiencing the worst outcomes.

���� b.� The Initiative for Disease
Control Maternal Mortality, a collaboration between the CDC Foundation, the
U.S. Centers for Disease Control and Prevention (CDC), and the Association of
Maternal and Child Health Programs, found that in the United States, Black
women are three to four times more likely to die from pregnancy-related
complications compared to white women.

���� c.� The CDC also found that
the maternal mortality rate for Black women is 46.5 deaths per 100,000 live
births, compared to 14.7 deaths per 100,000 live births for white women.� Black
women experience higher rates of preterm birth compared to white women at 14.1
percent, compared to 9.1 percent for white women, and Black women die from
pregnancy-related complications at three times the rate of white women.

���� d.� In New Jersey, these
statistics are even worse.� The Department of Health�s 2016-2018 Maternal
Mortality Report found that more than 90 percent of pregnancy-related deaths in
New Jersey were preventable, and in 2019, New Jersey was ranked 47th in the United
States for maternal deaths, and had one of the widest racial disparities for
both maternal and infant mortality.

���� e.� In 2023, the national
average of infant mortality was 5.67 per 1,000 live births, but that rate
nearly doubled for infants of Black women at 10.75 per 1,000 live births.� In
the same year, Black babies born in New Jersey had a higher infant mortality
rate than white babies, with Black infants 3.4 times more likely to die before
their first birthday than white babies.

���� f.� Implicit and explicit bias
and systemic racism plays a major role in pregnancy-related complications, and
studies have found that the structural racism Black women experience in the
health care delivery system, contributes significantly to higher rates of
preventable death during child birth compared to other racial and ethnic
groups.

���� g.� In New Jersey, Black women
have reported that healthcare providers often fail to listen to their
pregnancy-related needs and concerns, and the systemic racism created by
predominantly white healthcare institutions, the demise of Black midwifery, the
closure of maternity care units throughout the State, and the growth of birthing
deserts and maternal toxic zones have had an impact on Black birthing
outcomes.� This has led to racial disparities in the State�s Black maternal and
infant mortality rates.

���� h.� Such disparities are
particularly evident in predominately Black and Hispanic urban cities such as
Atlantic City, East Orange, Newark, Plainfield, and Trenton, which experience
the highest maternal and infant health disparities.� For example, Trenton is
among the cities with the highest rates of Black and Hispanic infant mortality,
and only 47 percent of mothers in Trenton receive prenatal care in their first
trimester.

���� i.� The Robert Wood Johnson
Foundation�s 2023 Maternal Health Fact Sheet highlighted that community
birthing initiatives have demonstrated effectiveness in reducing adverse
maternal outcomes. These initiatives emphasize holistic, culturally sensitive
care, often provided by midwives and doulas, whose presence during childbirth, can
decrease the likelihood of complications, such as unplanned cesarean sections,
which Black women disproportionately experience even after controlling for
medical risks.

���� j.� The Department of Health�s
2016-2018 Maternal Mortality Report also found that in predominately
underserved Black communities, there is a need for the State to create and
fully support community-birthing initiatives, specifically those that engage with
Black OBGYNs, midwives, doulas, and other medical professionals of similar
race, ethnicity, and nationality, if appropriate, in order to provide Black
women the most culturally congruent options for their health and the health of
their babies.

���� k.� In order to acknowledge
and address the racial and health disparities that have created a public health
crisis for Black women and their babies, it is necessary to create
community-led birth and wellness resource initiatives consisting of medical
professionals, staff, and services providing the necessary culturally congruent
care that is critical to ensuring healthy and positive birth outcomes in
communities like Atlantic City, East Orange, Newark, Plainfield, and Trenton.

���� l.� Black mothers and babies
are more likely to live and have positive health outcomes and experiences when
provided culturally congruent care by Black physicians, midwives, and doulas.� It
is therefore, in the best interest of the State to create a system of community-led
birthing and wellness resource initiatives that provide culturally congruent
maternal and infant health care services for, and promote the health and
wellness of, Black families in predominately underserved Black and Hispanic
urban core communities.

���� 3.� As used in this
act:

���� �Authority� means the New
Jersey Maternal and Infant Health Innovation Authority established pursuant to
section 4 of P.L.2023, c.109 (C.26:18-20).

���� �Community-led birth and
wellness resource initiative� means an initiative that is provided by a
community-based, faith-based, or non-profit organization that specializes in
advancing equitable and culturally congruent maternal and infant health
outcomes and promoting the health and wellness of families through advocacy,
education, support services, and community-based solutions, to historically
underserved or marginalized communities, focused on improving maternity care
and birthing outcomes for expectant mothers and infants.

���� �Culturally congruent care�
means care provided by a health care provider or clinician who shares the same
ethnicity and similar life experiences as a patient to reduce the likelihood of
negative health outcomes and to ensure that interactions with the patient are
reflective of the provider�s or clinician�s respect and understanding of the
patient�s culture, beliefs, values, and morals.

���� �Doula� means a trained
professional who provide continuous physical, emotional, and informational
support to a mother before, during, and shortly after childbirth, to help the
mother achieve the healthiest, most satisfying birthing experience possible.

���� �Low-income family� means a
family with an annual household income at or below the federal poverty level
based on family size.

���� �Midwife� means a certified
midwife, certified professional midwife, or certified nurse midwife.

���� �Program� means the �Community-led
Birth and Wellness Resource Initiative Program� established pursuant to section
4 of this act.

���� 4.� a.� There is established
the Community-led Birth and Wellness Resource Initiative Program in the New
Jersey Maternal Health Innovation Authority.� The goal of the program shall be
to address systemic barriers to quality health care, combat disparities in the
provision of maternal and infant health care, and promote reproductive justice by
empowering those most impacted by racial and health care inequities.

���� b.� The authority shall
contract with a minimum of five community-led birthing and wellness resource
initiatives located as follows:� one in Mercer County, one in Union County, one
in Atlantic County, and two in Essex County.� The authority shall contract with
other community-led birthing and wellness resource initiatives in additional
counties where there is a demonstrated need to address systemic barriers to
quality health care, combat disparities in the provision of maternal and infant
health care, and promote reproductive justice.

���� 5.� a.� A community-led birth
and wellness resource initiative contracted with the authority pursuant to
subsection b. of section 4 of this act shall:

���� (1) be located in, and predominantly
serve the low-income families of, a health professional shortage area as designated
by the United States Department of Health and Human Services, or a medically
underserved area as determined by the department, or any other underserved
community with a demonstrated need for such initiative;

���� (2) provide, at a minimum, the
following services to a low-income family residing in the county where the
initiative is located:

���� (a) prenatal and postpartum
visits, including home visitation, mental health care, and midwifery and doula
care services;

���� (b) lactation counseling, lactation
consultation, and nutrition services;

���� (c) parenting classes and
other parenting support services;

���� (d) infant, pediatric, and
primary health care services; and

���� (e) referrals to housing,
legal, financial, and other social support services; and

���� (3) provide a place for the
establishment of midwifery, doula, or other perinatal treatment professional
training programs.

���� b.� In order to meet the goals
of the program and to guarantee the services and care provided by each
community-led birth and wellness resource initiative reflect the community where
it is located, each initiative shall adopt and implement guidelines of
operation that shall, at a minimum, provide for:

���� (1) hiring practices that
ensure that more than 50 percent of the:

���� (a) physicians, midwives,
doulas, and other health care professionals employed by the initiative identify
as Black or African-American; and

���� (b) contractors engaged in the
construction of a new, or the renewal, renovation, expansion, improvement, or
reconstruction of an existing, building housing the initiative identify as
Black or African-American;

���� (2) the provision of culturally
congruent care, services, and supports to low-income families residing in the
county where the initiative is located;

���� (3) the creation of an
education and outreach program to train midwives and doulas in providing
culturally congruent midwifery and doula care services;

���� (4) policies and procedures
that encourages the retention of the physicians, midwives, doulas, and other
health care professionals hired by the initiative by providing wages, salaries,
and benefits commiserate to the market value of their positions, and any other forms
of financial assistance including, but not limited to, housing assistance, tax
incentives, and education and training; and

���� (5) procedures to apply for
and accept any grant of money from the State or federal government or other
sources, which may be available to community-led birth and wellness resource
initiatives which shall be deposited in the �Community-led Birth and Wellness
Resource Initiative Program Fund� established pursuant to section 6 of this
act.

���� 6.� a.� There is established
in the authority a fund to be known as the �Community-led Birth and Wellness
Resource Initiative Program Fund.�� This fund shall be the repository for
monies appropriated to support the program established pursuant to subsection
a. of section 4 of this act.

���� b.� The monies deposited in
the Community-led Birth and Wellness Resource Initiative Program Fund shall be
distributed by the authority to the community-led birthing justice and equity initiatives
contracted with authority pursuant to subsection b. of section 4 of this act to:

���� (1) establish or construct
new, or renew, renovate, improve, expand, or reconstruct existing buildings
housing community-led birth and wellness resource initiatives;

���� (2) hire personnel, fund
positions, and provide funding to establish the culturally congruent services
provided by the initiatives;

���� (3) engage in long-term
strategic planning; and

���� (4) fund any other purpose
that would enhance the effective and efficient operation of initiatives.

���� 7.� The President and Chief
Executive Officer of the authority shall annually report to the Governor, and
to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), on
the effectiveness of the Community-led Birth and Wellness Resource Initiative
Program, and the report shall include any recommendations for legislative
action that the President and the Chief Executive Officer deems appropriate.

���� 8.� Pursuant to the
"Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.),
the authority shall adopt any rules and regulations necessary to effectuate the
purposes of this act.

���� 9.� There is appropriated $12,000,000
from the General Fund to the authority for the purpose of contracting with community-led
birthing justice and equity initiatives to effectuate the purposes of section 6
of this act, of which $5,000,000 shall be allocated to faith-based
organizations with expertise in addressing disparities in maternal mortality
and morbidity rates.

���� 10.� This act shall take
effect on the first day of the third month next following enactment, except
that the authority may take any anticipatory administrative action in advance
as shall be necessary for the implementation of this act.

STATEMENT

This bill establishes the Community-led
Birth and Wellness Resource Initiative Program in the New Jersey Maternal and
Infant Health Innovation Authority (authority).� The goal of the program is to
address systemic barriers to quality health care, combat disparities in the
provision of maternal and infant health care, and promote reproductive justice
by empowering those most impacted by racial and health care inequities.

���� The authority is to contract with
a minimum of five community-led birthing and wellness resource initiatives
located in Mercer, Union, Atlantic, and Essex counties.� The authority is to
contract with other initiatives in additional counties as necessary.

���� A community-led birth and
wellness resource initiative contracted with the authority pursuant to the bill
is to:� be located in, and predominantly serve the low-income families of, a
health professional shortage area, a medically underserved area, or any other
underserved community with a demonstrated need for such initiative; and provide
services and adopt guidelines for operations as enumerated in the bill.

���� The bill establishes the �Community-led
Birth and Wellness Resource Initiative Program Fund� in the authority to be the
repository for the $12,000,000 appropriated to the program, of which $5,000,000
is to be allocated to faith-based organizations with expertise in disparities
in maternal mortality and morbidity rates.

���� The monies allocated to the
fund are to be distributed to community-led birth and wellness resource initiatives
to:� (1) establish or construct new, or renew, renovate, improve, expand, or
reconstruct existing community-led birth and wellness resource initiatives; (2)
hire personnel, fund positions, and provide for funding to establish the
culturally congruent services; (3) engage in long-term strategic planning; and (4)
fund any other purpose enhancing the effective and efficient operation of the initiatives.