senate Bill S7234

Signed by Governor Amended

Relates to the provision of maternal depression education, screening guidelines, and referrals for treatment

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Bill Status


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

  • 07 / May / 2014
    • REFERRED TO HEALTH
  • 20 / May / 2014
    • REPORTED AND COMMITTED TO FINANCE
  • 02 / Jun / 2014
    • 1ST REPORT CAL.1089
  • 03 / Jun / 2014
    • 2ND REPORT CAL.
  • 09 / Jun / 2014
    • AMENDED 7234A
  • 09 / Jun / 2014
    • ADVANCED TO THIRD READING
  • 16 / Jun / 2014
    • AMENDED ON THIRD READING 7234B
  • 19 / Jun / 2014
    • PASSED SENATE
  • 19 / Jun / 2014
    • DELIVERED TO ASSEMBLY
  • 19 / Jun / 2014
    • REFERRED TO WAYS AND MEANS
  • 19 / Jun / 2014
    • SUBSTITUTED FOR A9610B
  • 19 / Jun / 2014
    • ORDERED TO THIRD READING CAL.870
  • 19 / Jun / 2014
    • PASSED ASSEMBLY
  • 19 / Jun / 2014
    • RETURNED TO SENATE
  • 31 / Jul / 2014
    • DELIVERED TO GOVERNOR
  • 04 / Aug / 2014
    • SIGNED CHAP.199

Summary

Relates to the provision of maternal depression education, screening guidelines, and referrals for treatment.

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Bill Details

See Assembly Version of this Bill:
A9610
Versions:
S7234
S7234A
S7234B
Legislative Cycle:
2013-2014
Law Section:
Public Health Law
Laws Affected:
Add §§2500-k, amd §§207, 2803-j & 2803-n, Pub Health L; add §§3217-g & 4306-f, Ins L

Votes

Sponsor Memo

BILL NUMBER:S7234

TITLE OF BILL: An act to amend the public health law and the
insurance law, in relation to the provision of maternal depression
education, screening guidelines, and referrals for treatment

PURPOSE: This bill would define maternal depression; provide
information and guidelines on maternal depression screening; provide
information on follow-up support and referrals; 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
provide information on maternal depression to maternal health care
providers. The information shall include a summary of the current
evidence base and professional guidelines for maternal depression
screening. The information shall also include validated,
evidence-based tools for providers to use to screen patients for
maternal depression. The other parent of the child and other family
members, as consistent with patient confidentiality, may be included
in dialogue about maternal depression in order to help them better
understand maternal depression. The commissioner shall also provide
information on follow-up support for patients when the screening
results show the need for further evaluation, referral, or treatment
of maternal depression. This shall also include information on
available community resources and entities licensed by the office of
mental health, such as treatment providers, support groups and
not-for-for-profit organizations.

Section 2 adds paragraph (j) to subdivision 1 of section 207 of the
Public Health Law to include maternal depression on the list of health
care 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 the information contained in maternity related leaflets
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 and update
the information contained in the leaflets that are distributed to
maternity patients before they are discharged from a hospital. 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, and
education on maternal depression screening and referrals to hospital
care for maternity patients.

Section 6 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. This is a


procedural provision, not a benefit mandate, and clarifies that health
insurers shall not require a referral from a primary care practitioner
for this service.

Section 7 adds a new section 4306-f to the Insurance Law on screening
for maternal depression. No corporation shall limit a patient's direct
access to maternal depression screening and referral. This is a
procedural provision, not a benefit mandate, and clarifies that health
insurers shall not require a referral from a primary care practitioner
for this service.

Section 8 adds a new section 4406-f to the Public Health Law on
screening for maternal depression. No health maintenance organization
shall limit an enrollee's direct access to maternal depression
screening and referral. This is a procedural provision, not a benefit
mandate, and clarifies that health insurers shall not require a
referral from a primary care practitioner for this service.

Section 9 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. Women whose maternal depression is severe
enough to be considered postpartum psychosis have a five percent
suicide rate and four percent infanticide rate.

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, and
economic boundaries and requires increased education and 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: 2013: S3137C/A7667B - PBH - Vetoed by the
Governor - veto #269. 2012: S7355.

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 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
________________________________________________________________________

                                  7234

                            I N  S E N A T E

                               May 7, 2014
                               ___________

Introduced  by  Sen. KRUEGER -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law and the insurance law, in relation
  to the provision of maternal depression  education,  screening  guide-
  lines, and referrals for treatment

  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 INFORMATION. (A) THE COMMISSIONER, IN CONSULTA-
TION WITH THE COMMISSIONER OF MENTAL HEALTH,  SHALL  MAKE  AVAILABLE  TO
MATERNAL  HEALTH  CARE PROVIDERS INFORMATION ON MATERNAL DEPRESSION. THE
INFORMATION SHALL INCLUDE, BUT NOT BE LIMITED TO:
  (I) A SUMMARY OF THE CURRENT EVIDENCE BASE AND PROFESSIONAL GUIDELINES
FOR MATERNAL DEPRESSION SCREENING;
  (II) VALIDATED, EVIDENCE-BASED TOOLS FOR MATERNAL  DEPRESSION  SCREEN-
ING;
  (III) INFORMATION ABOUT FOLLOW-UP SUPPORT FOR PATIENTS WHO MAY REQUIRE
FURTHER  EVALUATION,  REFERRAL,  OR TREATMENT INCLUDING, WHEN AVAILABLE,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD14648-05-4

S. 7234                             2

INFORMATION ABOUT SPECIFIC COMMUNITY RESOURCES AND ENTITIES LICENSED  BY
THE OFFICE OF MENTAL HEALTH; AND
  (IV) INFORMATION ON ENGAGING SUPPORT FOR THE MOTHER, WHICH MAY INCLUDE
COMMUNICATING  WITH  THE  OTHER  PARENT  OF  THE  CHILD AND OTHER FAMILY
MEMBERS, AS APPROPRIATE AND CONSISTENT WITH PATIENT CONFIDENTIALITY.
  (B) THE INFORMATION ON MATERNAL DEPRESSION  SHALL  BE  POSTED  ON  THE
OFFICE'S  WEBSITE.  THE  COMMISSIONER  SHALL,  IN COLLABORATION WITH THE
COMMISSIONER OF MENTAL HEALTH, UPDATE  AND  REVIEW  THE  INFORMATION  ON
MATERNAL DEPRESSION, AS NECESSARY.
  3.  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 (j) to read as follows:
  (J)   MATERNAL  DEPRESSION,  INCLUDING  INFORMATION  ABOUT  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 CONTAINED IN THE LEAFLET 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 [post-partum] MATERNAL depression. THE  COMMISSIONER,  IN  COLLAB-
ORATION  WITH THE COMMISSIONER OF MENTAL HEALTH, SHALL REVIEW AND UPDATE
THE INFORMATION ON MATERNAL DEPRESSION  CONTAINED  IN  THE  LEAFLET,  AS
NECESSARY.  THE  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:
  (b) Maternity care shall also include, at minimum,  parent  education,
assistance and training in breast or bottle feeding, EDUCATION ON MATER-
NAL  DEPRESSION,  EDUCATION  ON MATERNAL DEPRESSION SCREENING AND REFER-
RALS, and the performance of any necessary maternal and newborn clinical
assessments.  Notwithstanding this requirement, nothing  in  this  para-
graph is intended to result in the hospital charging any amount for such
services  in  addition  to the applicable charge for the maternity inpa-
tient hospital admission.
  S 6. 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

S. 7234                             3

INSURED'S   DIRECT   ACCESS  TO  SCREENING  AND  REFERRAL  FOR  MATERNAL
DEPRESSION,  AS  DEFINED  IN  SUBDIVISION  ONE  OF  SECTION  TWENTY-FIVE
HUNDRED-K  OF  THE  PUBLIC  HEALTH  LAW, FROM A PROVIDER OF OBSTETRICAL,
GYNECOLOGIC,  OR  PEDIATRIC  SERVICES  OF  HER CHOICE; PROVIDED THAT THE
PATIENT INSURED'S CHOICE OF PROVIDER IS SUBJECT TO THE TERMS AND  CONDI-
TIONS OF THE POLICY UNDER WHICH THE PATIENT INSURED IS COVERED.
  S  7.  The  insurance law is amended by adding a new section 4306-f to
read as follows:
  S 4306-F. MATERNAL DEPRESSION SCREENINGS. NO  CORPORATION  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,  AS  DEFINED  IN  SUBDIVISION  ONE  OF  SECTION  TWENTY-FIVE
HUNDRED-K OF THE PUBLIC HEALTH LAW,  FROM  A  PROVIDER  OF  OBSTETRICAL,
GYNECOLOGIC,  OR  PEDIATRIC  SERVICES  OF  HER CHOICE; PROVIDED THAT THE
PATIENT INSURED'S CHOICE OF PROVIDER IS SUBJECT TO THE TERMS AND  CONDI-
TIONS OF THE CONTRACT UNDER WHICH THE PATIENT INSURED IS COVERED.
  S  8.  The public health law is amended by adding a new section 4406-f
to read as follows:
  S 4406-F. MATERNAL DEPRESSION SCREENINGS. NO HEALTH MAINTENANCE ORGAN-
IZATION SUBJECT TO THIS ARTICLE SHALL BY  CONTRACT,  WRITTEN  POLICY  OR
PROCEDURE  LIMIT  A  PATIENT  ENROLLEE'S  DIRECT ACCESS TO SCREENING AND
REFERRAL FOR MATERNAL DEPRESSION,  AS  DEFINED  IN  SUBDIVISION  ONE  OF
SECTION  TWENTY-FIVE  HUNDRED-K  OF  THIS  CHAPTER,  FROM  A PROVIDER OF
OBSTETRICAL, GYNECOLOGIC, OR PEDIATRIC SERVICES OF HER CHOICE;  PROVIDED
THAT  THE  PATIENT  INSURED'S CHOICE OF PROVIDER IS SUBJECT TO THE TERMS
AND CONDITIONS OF THE PLAN UNDER WHICH THE PATIENT ENROLLEE IS COVERED.
  S 9. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided that (a) sections  six,  seven  and
eight  of  this  act  shall  apply to all policies and contracts issued,
renewed, modified, altered, 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  neces-
sary for the implementation of this act on its effective date is author-
ized to be made and completed by the commissioner of health on or before
such effective date.

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