senate Bill S3137B

Amended

Defines maternal depression, requires the provision of maternal depression education, and the provision of a screening and referral plan for the state

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 30 / Jan / 2013
    • REFERRED TO HEALTH
  • 29 / May / 2013
    • AMEND (T) AND RECOMMIT TO HEALTH
  • 29 / May / 2013
    • PRINT NUMBER 3137A
  • 10 / Jun / 2013
    • AMEND AND RECOMMIT TO HEALTH
  • 10 / Jun / 2013
    • PRINT NUMBER 3137B
  • 12 / Jun / 2013
    • AMEND AND RECOMMIT TO HEALTH
  • 12 / Jun / 2013
    • PRINT NUMBER 3137C

Summary

Defines maternal depression; requires the provision of maternal depression education, and the provision of a screening and referral plan for the state.

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Bill Details

See Assembly Version of this Bill:
A7667A
Versions:
S3137
S3137A
S3137B
S3137C
Legislative Cycle:
2013-2014
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Add §2500-k, amd §§207, 2803-j & 2803-n, Pub Health L; amd §§3216 & 4303, add §3217-g, Ins L
Versions Introduced in 2011-2012 Legislative Cycle:
S7355, S7355

Sponsor Memo

BILL NUMBER:S3137B

TITLE OF BILL: An act to amend the public health law and the
insurance law, in relation to developing a maternal depression
screening and referral plan for the state, and providing maternal
depression education

PURPOSE: This bill would define maternal depression; develop
guidelines for maternal depression screening and referrals; make
available a comprehensive referral list for treatment of maternal
depression; and provide public education to promote awareness of and
de-stigmatize maternal depression. In addition, legislation is
intended to ensure that State residents are informed of the public
health services that will help them understand, identify and treat
maternal depression.

SUMMARY OF SPECIFIC PROVISIONS:

Section 1 adds a new section 2500-k to the Public Health Law that
defines maternal depression and maternal health care provider. This
section also authorizes the commissioner to establish maternal
depression screening guidelines for the state, including the routine
employment of screening at regular intervals during pregnancy and
after childbirth. The commissioner shall identify validated,
evidence-based diagnostic tools for maternal health care providers to
use to screen patients for maternal depression. Fathers and other
family members, as appropriate and consistent with patient
confidentiality, shall be included in dialogue about maternal
depression in order to help them better understand maternal
depression. The commissioner shall develop an appropriate referral
mechanism for maternal health care providers to use when the screening
results show the need for further evaluation and treatment of maternal
depression.

Section 2 adds paragraph (i) to subdivision 1 of section 207 of the
Public Health Law to include maternal depression on the list of
healthcare and wellness education and outreach programs that may be
conducted by the Department of Health.

Section 3 amends subdivision 1 of section 2803-j of the Public Health
Law to make leaflets that contain maternity related information
available on the Department of Health's website.

Section 4 amends paragraph (b) of subdivision 1 of section 2803-j of
the Public Health Law to require the commissioner to review the
maternal depression informational leaflets that are distributed to
patients before they are discharged from a hospital. The leaflets
shall address the various forms of maternal depression and provide
resources for treatment of maternal depression. The leaflets shall
also be made available in the top six languages spoken in the state,
besides English.

Section 5 amends paragraph (b) of subdivision 1 of section 2803-n of
the Public Health Law by adding maternal depression education,
screening and referral to hospital care for maternity patients.


Section 6 amends item (ii) of subparagraph (A) of paragraph 10 of
subdivision (i) of section 3216 of the Insurance Law by adding
maternal depression education, screening and referral to maternity
care coverage.

Section 7 amends subparagraph (A) of paragraph 5 of subsection (k) of
section 3221 of the Insurance Law by adding maternal depression
education, screening and referral to maternity care coverage.

Section 8 amends subparagraph (B) of paragraph 1 of subsection (c) of
section 4303 of the Insurance Law by adding maternal depression
education, screening and referral to maternity care coverage.

Section 9 adds a new section 3217-g to the Insurance Law on screening
for maternal depression. No insurer shall limit a patient's direct
access to maternal depression screening and referral.

Section 10 establishes an effective date.

JUSTIFICATION: Maternal depression is broadly defined as a wide range
of emotional and psychological reactions a woman may experience during
pregnancy or after childbirth. These reactions may include, but are
not limited to, feelings of despair or extreme guilt, prolonged
sadness, lack of energy, difficulty concentrating, fatigue, extreme
changes in appetite, and thoughts of suicide or of harming the baby.
These reactions may occur without warning and may happen before,
during, or immediately after childbirth, and continue into the
infant's first year of life.

Maternal depression may include prenatal depression, the "baby blues,"
postpartum depression, and postpartum psychosis. Each year,
approximately ten to fifteen percent of mothers and twenty-two percent
of multi-ethnic inner city mothers develop postpartum depression;
50-80 percent of new mothers will get "baby blues"; and 0.1-0.2
percent of new mothers develop postpartum psychosis. Postpartum
psychosis, the most severe form of maternal depression, usually
includes auditory hallucinations and delusions, and in some cases
visual hallucinations. Postpartum psychosis has a five percent suicide
rate and four percent rate of infanticide, or death of an infant.

Often, the symptoms of maternal depression are not immediately
identified because they closely resemble those generally associated
with pregnancy. As a result, maternal depression is sometimes left
untreated, and may result in a detrimental impact on the entire
family, especially the newborn and other children in the family.
Children of mothers with maternal depression are at higher risk for
serious developmental, behavioral, and emotional problems. The
immediate family is often unaware and/or unsure how to offer support.
A mother experiencing depression does not often disclose her condition
due to feelings of shame, and the severity of the condition worsens.

Maternal depression is often undetected and untreated by maternal
health care providers due to both lack of training in identifying the
condition and lack of support both professionally and financially, as
well as concerns about the availability of treatment options and
coverage identified with maternal depression.


Early screening and identification of postpartum depression has an 80
to 90 percent success rate and offers long-term health care costs
savings. It also helps support healthy child development and addresses
issues of early childhood mental health challenges.

Women typically visit their obstetrician and gynecologist during
pregnancy and visit the pediatrician for their infant's check-ups more
often than they would any other health professional. Therefore, these
maternal health care providers are in an ideal position to screen
women for maternal depression.

Maternal depression is an epidemic that crosses racial, ethnic,
economic boundaries and requires a universal screening to identify
patients who need help. It also requires a high-quality network of
accessible treatment options to deliver help and public support so
that families and babies have a truly healthy start.

PRIOR LEGISLATIVE HISTORY: None

FISCAL IMPLICATIONS: To be determined

EFFECTIVE DATE: This act shall take effect on the one hundred
eightieth day next succeeding the date on which it shall have become a
law; provided, however, that effective immediately, the addition,
amendment and/or repeal of any rule or regulation necessary for the
implementation of this act on its effective date is authorized and
directed to be made and completed by the commissioner of health on or
before such effective date.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 3137--B

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 30, 2013
                               ___________

Introduced  by  Sen. KRUEGER -- read twice and ordered printed, and when
  printed to be committed  to  the  Committee  on  Health  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to  said  committee  --  committee  discharged,  bill amended, ordered
  reprinted as amended and recommitted to said committee

AN ACT to amend the public health law and the insurance law, in relation
  to developing a maternal depression screening and  referral  plan  for
  the state, and providing maternal depression education

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The public health law is amended by adding  a  new  section
2500-k to read as follows:
  S  2500-K.  MATERNAL  DEPRESSION.  1.  DEFINITIONS.    AS USED IN THIS
SECTION:
  (A) "MATERNAL DEPRESSION" MEANS A WIDE RANGE OF EMOTIONAL AND  PSYCHO-
LOGICAL  REACTIONS  A  WOMAN  MAY  EXPERIENCE  DURING PREGNANCY OR AFTER
CHILDBIRTH. THESE REACTIONS MAY INCLUDE, BUT ARE NOT LIMITED  TO,  FEEL-
INGS  OF  DESPAIR  OR  EXTREME GUILT, PROLONGED SADNESS, LACK OF ENERGY,
DIFFICULTY CONCENTRATING, FATIGUE,  EXTREME  CHANGES  IN  APPETITE,  AND
THOUGHTS  OF  SUICIDE  OR  OF  HARMING THE BABY. MATERNAL DEPRESSION MAY
INCLUDE PRENATAL DEPRESSION, THE "BABY BLUES," POSTPARTUM DEPRESSION, OR
POSTPARTUM PSYCHOSIS-THE SEVEREST FORM.
  (B) "MATERNAL HEALTH CARE PROVIDER" MEANS A PHYSICIAN, MIDWIFE,  NURSE
PRACTITIONER,  OR PHYSICIAN ASSISTANT, OR OTHER HEALTH CARE PRACTITIONER
ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE, ATTENDING A  PREGNANT
WOMAN  OR  A  WOMAN UP TO ONE YEAR AFTER CHILDBIRTH, INCLUDING A PRACTI-
TIONER ATTENDING THE WOMAN'S CHILD UP TO ONE YEAR AFTER CHILDBIRTH.
  2. MATERNAL DEPRESSION SCREENING. (A) THE COMMISSIONER,  IN  CONSULTA-
TION   WITH   THE   COMMISSIONER   OF  MENTAL  HEALTH,  SHALL  ESTABLISH
EVIDENCE-BASED GUIDELINES FOR MATERNAL DEPRESSION SCREENING FOR  USE  BY
MATERNAL  HEALTH CARE PROVIDERS AND PEDIATRIC PRIMARY CARE PROVIDERS. IN

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01525-05-3

S. 3137--B                          2

DEVELOPING GUIDELINES UNDER  THIS  SECTION,  THE  COMMISSIONER  AND  THE
COMMISSIONER  OF MENTAL HEALTH SHALL CONSULT APPROPRIATE MATERNAL HEALTH
CARE PROVIDERS. SUCH GUIDELINES SHALL INCLUDE, BUT NOT BE LIMITED TO:
  (I) THE IDENTIFICATION OF SUGGESTED VALIDATED, EVIDENCE-BASED DIAGNOS-
TIC TOOLS TO BE USED FOR MATERNAL DEPRESSION SCREENING;
  (II)  THE  ROUTINE  EMPLOYMENT  OF  VALIDATED, EVIDENCE-BASED MATERNAL
DEPRESSION SCREENING TOOLS AT REGULAR  INTERVALS  DURING  PREGNANCY  AND
AFTER CHILDBIRTH; AND
  (III)  AN  APPROPRIATE  REFERRAL  MECHANISM  FOR  PATIENTS WHO REQUIRE
FURTHER EVALUATION, SERVICES, OR TREATMENT.
  (B) MATERNAL DEPRESSION SCREENING AND REFERRAL  MAY  INCLUDE  COMMUNI-
CATION  WITH THE FATHER OF THE CHILD AND OTHER FAMILY MEMBERS, AS APPRO-
PRIATE AND CONSISTENT WITH PATIENT CONFIDENTIALITY.
  3. REFERRALS FOR MATERNAL DEPRESSION TREATMENT. THE COMMISSIONER SHALL
MAKE AVAILABLE A LIST OF PROVIDERS FOR TREATMENT OF MATERNAL DEPRESSION,
INCLUDING SUPPORT GROUPS AND SERVICES PROVIDED BY NOT-FOR-PROFIT  ORGAN-
IZATIONS.
  4.  THE COMMISSIONER SHALL MAKE ANY REGULATIONS NECESSARY TO IMPLEMENT
THIS SECTION.
  S 2. Subdivision 1 of section 207 of the public health law is  amended
by adding a new paragraph (i) to read as follows:
  (I)  MATERNAL  DEPRESSION,  INCLUDING  EDUCATION,  SCREENING, REFERRAL
SERVICES, AND POSSIBLE OPTIONS FOR TREATMENT.
  S 3. Subdivision 1 of section 2803-j of  the  public  health  law,  as
amended  by  chapter  62  of  the  laws  of  1996, is amended to read as
follows:
  1. The commissioner shall require that every hospital and birth center
shall prepare in printed or photocopied form and distribute at the  time
of  pre-booking directly to each prospective maternity patient and, upon
request, to the general public an informational  leaflet.  Such  leaflet
shall  be  designed  by  the  commissioner and shall contain brief defi-
nitions of maternity related procedures and practices  as  specified  in
subdivision two of this section and such other material as deemed appro-
priate  by the commissioner.  Hospitals and birth centers may also elect
to distribute additional explanatory material along with  the  maternity
patients informational leaflet. THE COMMISSIONER SHALL MAKE THE INFORMA-
TION LEAFLETS AVAILABLE ON THE DEPARTMENT'S WEBSITE.
  S  4.  Subdivision  1-b of section 2803-j of the public health law, as
added by chapter 647 of the laws of 1997, is amended to read as follows:
  1-b. The informational leaflet shall also include information relating
to the physical  and  mental  health  of  the  maternity  patient  after
discharge  from the hospital, including, but not limited to, information
about  MATERNAL  AND  post-partum  depression.  THE  COMMISSIONER  SHALL
PERFORM  A  REVIEW OF INFORMATION ON MATERNAL AND POST-PARTUM DEPRESSION
IN INFORMATIONAL LEAFLETS, IN COLLABORATION  WITH  THE  COMMISSIONER  OF
MENTAL  HEALTH,  TO  EVALUATE  THE  CONTENTS FOR ADDRESSING ALL FORMS OF
MATERNAL AND  POST-PARTUM  DEPRESSION,  AND  IDENTIFYING  RESOURCES  FOR
OBTAINING  HELP  FOR THE PATIENTS AND THEIR FAMILIES. ALL INFORMATION ON
MATERNAL AND POST-PARTUM DEPRESSION IN INFORMATIONAL LEAFLETS  SHALL  BE
MADE AVAILABLE TO PATIENTS IN THE TOP SIX LANGUAGES SPOKEN IN THE STATE,
OTHER  THAN  ENGLISH,  ACCORDING  TO  THE LATEST AVAILABLE DATA FROM THE
UNITED STATES CENSUS BUREAU.
  S 5. Paragraph (b) of subdivision 1 of section 2803-n  of  the  public
health  law,  as  added by chapter 56 of the laws of 1996, is amended to
read as follows:

S. 3137--B                          3

  (b) Maternity care shall also include, at minimum,  parent  education,
assistance and training in breast or bottle feeding, EDUCATION ON MATER-
NAL  DEPRESSION  AND MATERNAL DEPRESSION SCREENING AND REFERRAL, and the
performance of any necessary maternal and newborn clinical  assessments.
Notwithstanding  this requirement, nothing in this paragraph is intended
to result in the hospital charging any amount for such services in addi-
tion to the applicable  charge  for  the  maternity  inpatient  hospital
admission.
  S  6. Item (ii) of subparagraph (A) of paragraph 10 of subdivision (i)
of section 3216 of the insurance law, as added by chapter 56 of the laws
of 1996, is amended to read as follows:
  (ii) Maternity care coverage shall also include,  at  minimum,  parent
education,  assistance  and training in breast or bottle feeding, EDUCA-
TION ON MATERNAL DEPRESSION AND MATERNAL DEPRESSION SCREENING AND REFER-
RAL, and the performance of any necessary maternal and newborn  clinical
assessments.
  S 7. Item (ii) of subparagraph (A) of paragraph 5 of subsection (k) of
section 3221 of the insurance law, as added by chapter 56 of the laws of
1996, is amended to read as follows:
  (ii)  Maternity  care  coverage shall also include, at minimum, parent
education, assistance and training in breast or bottle  feeding,  EDUCA-
TION ON MATERNAL DEPRESSION AND MATERNAL DEPRESSION SCREENING AND REFER-
RAL,  and the performance of any necessary maternal and newborn clinical
assessments.
  S 8. Subparagraph (B) of paragraph 1 of subsection (c) of section 4303
of the insurance law, as amended by chapter 661 of the laws of 1997,  is
amended to read as follows:
  (B)  Maternity  care  coverage  also shall include, at minimum, parent
education, assistance and training in breast or bottle  feeding,  EDUCA-
TION ON MATERNAL DEPRESSION AND MATERNAL DEPRESSION SCREENING AND REFER-
RAL,  and the performance of any necessary maternal and newborn clinical
assessments.
  S 9. The insurance law is amended by adding a new  section  3217-g  to
read as follows:
  S  3217-G. MATERNAL DEPRESSION SCREENINGS.  NO INSURER SUBJECT TO THIS
ARTICLE SHALL BY CONTRACT, WRITTEN POLICY OR PROCEDURE LIMIT  A  PATIENT
INSURED'S   DIRECT   ACCESS  TO  SCREENING  AND  REFERRAL  FOR  MATERNAL
DEPRESSION FROM A PROVIDER OF  OBSTETRICAL,  GYNECOLOGIC,  OR  PEDIATRIC
SERVICES.
  S  10.  This  act  shall  take effect on the one hundred eightieth day
after it shall have become a law; provided that (a) sections six, seven,
eight and nine of this  act  shall  apply  to  contracts  entered  into,
amended  or  delivered  on  or after the first of January after this act
becomes a law; and (b) effective immediately,  the  addition,  amendment
and/or repeal of any rule or regulation necessary for the implementation
of  this act on its effective date is authorized and directed to be made
and completed by the commissioner of health on or before such  effective
date.

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