The National Academy for State Health Policy (NASHP), with support from the Health Resources and Services Administration’s Maternal and Child Health Bureau, invites states to apply to participate in the Advancing State Strategies to Address Maternity Care Deserts Policy Academy. The policy academy will engage at least six teams of state health officials (e.g. public health, Medicaid, behavioral health, provider groups, etc.) to support and advance innovative state-level policy initiatives that address the growth of maternity care deserts and improve access to quality health care for the maternal and child health population.
The maternal mortality rate in the United States remains far higher than peer countries, and significant disparities in maternal outcomes persist. The U.S. is also experiencing a growth of maternity care deserts—places with no hospitals or birth centers offering obstetric care and limited obstetric providers — in both urban and rural areas. A recent 2024 report indicates that more than 35 percent of U.S. counties are maternity care deserts and nearly 2.3 million women of reproductive age live in maternity care deserts. Over half of the counties in the U.S. do not have a hospital that provides obstetric care and over 2.5 million women of reproductive age live in a county without an obstetric clinician.
Details about the NASHP policy academy and application process are provided below. States interested in this opportunity are encouraged to participate in an informational webinar on March 25, 2025. States considering applying to participate in the policy academy should contact Robin Buskey at rbuskey@nashp.org to receive the application materials. All state applications should be submitted to rbuskey@nashp.org by 5:00 pm ET on Friday, April 25, 2025.
What are the Benefits for Participating States?
The policy academy will support states to strengthen, enhance and/or implement policy innovations that improve access to maternity care services for pregnant women who live in maternity care deserts. As a result of participating in this policy academy, state teams will:
- Identify and assess areas in need of change related to improving of access to maternity care services for pregnant women living in maternity care deserts;
- Identify and advance policy innovations and strategies and to improve access to maternity care services;
- Receive technical assistance provided by NASHP and other national and state experts and share relevant experiences with other participating state teams; and
- Strengthen partnerships with other sectors and convene multidisciplinary teams (e.g., Medicaid, public health, provider groups, health plans, community-based organizations).
Areas of Focus: Improving Access to Maternity Care
State teams will identify, develop, and strengthen policy strategies to address maternity care deserts, including factors that can impact health care access (e.g., financial resources, geographic location, transportation). Potential areas of focus and approaches that states can leverage include but are not limited to:
- Assessing the extent of maternity care deserts through data mapping and other related strategies, such as identifying models for mapping data on jurisdictions with limited or no access to maternity care to identify gaps and inform policy and program approaches to provide services.
- Supporting new and enhanced maternity care delivery models and strategies to improve access to care, such as identifying strategies to strengthen collaboration across health care facilities and providers to implement maternity care delivery models (e.g., telehealth, interprofessional consultation, mobile care units) to serve areas with limited or no maternity care providers.
- Strengthening the perinatal workforce, such as supporting the perinatal provider and professional workforce (e.g., midwives, doulas, community health workers, home visitors, mental health providers, and peer counselors) through Medicaid reimbursement for maternity care services.
- Conducting quality assurance, monitoring, and improvement to ensure high-quality perinatal care, such as ensuring high-quality patient care and safety in lower birth-volume hospitals (e.g., standardizing clinical care, addressing barriers to implementing patient safety protocols in these settings).
- Strengthening payment and financing strategies for perinatal care, such as advancing strategies to leverage 12 months of Medicaid and CHIP postpartum coverage to address barriers to accessing timely and high-quality postpartum care.
State Team Requirements
Each state team must meet the following criteria:
- Identification of 3–5 team members with roles or expertise that would be beneficial to your state’s identified goals and priorities, including the following state representatives:
- Required state team representatives:
- State Medicaid agency senior staff
- State Title V MCH senior staff
- Optional state team partner representatives:
- Representative from state and/or local Perinatal Quality Collaborative
- State behavioral health agency staff (e.g., lead on women’s health)
- Provider/hospital groups (e.g., primary care association, family physicians, hospital associations)
- Community-based professional groups (e.g., midwives, doulas, community health workers)
- Medicaid managed care plan(s)
- Family representative
- Other, as determined by state
- Required state team representatives:
- Willingness to receive technical assistance and participate in collaborative learning, including:
- Regular check-in calls (at least five during the policy academy)
- State-to-state webinars (at least six during the policy academy)
- In-person meetings (at least three during the policy academy; NASHP will support travel for up to three state team members)
- A closed listserv of participating state teams
- State commitment to improving access to quality maternity health care for the MCH population
- Demonstrated history of, or commitment to future, cross-agency collaboration
Policy Academy Timeline
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March 17, 2025: Request for Applications released
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March 25, 2025: NASHP informational webinar
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April 25, 2025: State applications due to NASHP
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May 2025*: Selected state teams notified
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June 2025*: Policy academy kick-off call
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June 2025 – June 2027*: Targeted technical assistance, peer-to-peer webinars, and calls
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Fall 2025, June 2026 and 2027*: In-person meetings
*Exact dates will be confirmed at a later date.
Application Process
- Email Robin Buskey at rbuskey@nashp.org to let us know that your state is considering or interested in applying to NASHP’s Advancing State Strategies to Address Maternity Care Deserts Policy Academy.
- The email should include your state’s team lead and/or key point of contact and their contact information (title, agency, work phone, and email).
- After emailing to express interest, the state team lead/key contact will be provided with a brief application. Each state team should complete this application and submit it to rbuskey@nashp.org by 5:00 p.m. ET on Friday, April 25, 2025.
- NASHP will review states’ applications and select states to participate in the policy academy. All states that applied will receive notification in May 2025.
Please direct any questions about the Advancing State Strategies to Address Maternity Care Deserts Policy Academy or NASHP’s application process to Robin Buskey at rbuskey@nashp.org.
