senate Bill S7234B

Signed By Governor
2013-2014 Legislative Session

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

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Sponsored By

Archive: Last Bill Status - Signed by Governor


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

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Aug 04, 2014 signed chap.199
Jul 31, 2014 delivered to governor
Jun 19, 2014 returned to senate
passed assembly
ordered to third reading cal.870
substituted for a9610b
referred to ways and means
delivered to assembly
passed senate
Jun 16, 2014 amended on third reading 7234b
Jun 09, 2014 advanced to third reading
amended 7234a
Jun 03, 2014 2nd report cal.
Jun 02, 2014 1st report cal.1089
May 20, 2014 reported and committed to finance
May 07, 2014 referred to health

Votes

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Bill Amendments

Original
A
B (Active)
Original
A
B (Active)

Co-Sponsors

S7234 - Bill Details

See Assembly Version of this Bill:
A9610B
Law Section:
Public Health Law
Laws Affected:
Add §§2500-k & 4406-f, amd §§207, 2803-j & 2803-n, Pub Health L; add §§3217-g & 4306-f, Ins L

S7234 - Bill Texts

view summary

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

view 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.

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                    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.

Co-Sponsors

view additional co-sponsors

S7234A - Bill Details

See Assembly Version of this Bill:
A9610B
Law Section:
Public Health Law
Laws Affected:
Add §§2500-k & 4406-f, amd §§207, 2803-j & 2803-n, Pub Health L; add §§3217-g & 4306-f, Ins L

S7234A - Bill Texts

view summary

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

view sponsor memo
BILL NUMBER:S7234A

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, legis-
lation 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-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 proce-
dural provision, not a benefit mandate, and clarifies that health insur-
ers 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 proce-
dural provision, not a benefit mandate, and clarifies that health insur-
ers 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 screen-
ing 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, 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. 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, approximate-
ly ten to fifteen percent of mothers and twenty-two percent of multieth-
nic 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 psycho-
sis have a five percent suicide rate and four percent infanticide rate.

Often, the symptoms of maternal depression are not immediately identi-
fied because they closely resemble those generally associated with preg-

nancy. 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, behav-
ioral, 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 iden-
tified 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 preg-
nancy 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.

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

                                 7234--A
    Cal. No. 1089

                            I N  S E N A T E

                               May 7, 2014
                               ___________

Introduced  by  Sens.  KRUEGER,  CARLUCCI, MONTGOMERY, PERKINS, SERRANO,
  TKACZYK -- read twice and ordered printed,  and  when  printed  to  be
  committed  to  the Committee on Health -- reported favorably from said
  committee and committed to the Committee on Finance -- reported favor-
  ably from said committee, ordered to first and second report,  amended
  on  second  report, ordered to a third reading, and to be reprinted as
  amended, retaining its place in the order of third reading

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:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD14648-08-4

S. 7234--A                          2

  (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,
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
DEPARTMENT'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

S. 7234--A                          3

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.  TO  THE  EXTENT  A  POLICY
PROVIDES  COVERAGE FOR MATERNAL DEPRESSION SCREENING, 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,  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. TO THE EXTENT A CONTRACT
PROVIDES COVERAGE FOR  MATERNAL  DEPRESSION  SCREENING,  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  CONDITIONS  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.  TO  THE  EXTENT  A PLAN
PROVIDES COVERAGE FOR MATERNAL DEPRESSION SCREENING, NO  HEALTH  MAINTE-
NANCE  ORGANIZATION  SUBJECT  TO THIS ARTICLE SHALL BY CONTRACT, WRITTEN
POLICY OR PROCEDURE LIMIT A PATIENT ENROLLEE'S DIRECT ACCESS TO  SCREEN-
ING  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 ENROLLEE'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.

Co-Sponsors

view additional co-sponsors

S7234B (ACTIVE) - Bill Details

See Assembly Version of this Bill:
A9610B
Law Section:
Public Health Law
Laws Affected:
Add §§2500-k & 4406-f, amd §§207, 2803-j & 2803-n, Pub Health L; add §§3217-g & 4306-f, Ins L

S7234B (ACTIVE) - Bill Texts

view summary

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

view sponsor memo
BILL NUMBER:S7234B

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-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, provided that
the patient's access to such services, coverage and choice of provider
is otherwise subject to the terms and conditions of the policy.
"Otherwise subject to" means that the terms and conditions apply to
the extent that they are not inconsistent with this provision. 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 provided that the
patient's access to such services, coverage and choice of provider is
otherwise subject to the terms and conditions of the contract.
"Otherwise subject to" means that the terms and conditions apply to
the extent that they are not inconsistent with this provision. 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 provided that the patient's access to such
services, coverage and choice of provider is otherwise subject to the
terms and conditions of the plan. "Otherwise subject to" means that
the terms and conditions apply to the extent that they are not
inconsistent with this provision. 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 multiethnic 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.

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

                                 7234--B
    Cal. No. 1089

                            I N  S E N A T E

                               May 7, 2014
                               ___________

Introduced  by  Sens.  KRUEGER,  CARLUCCI,  MONTGOMERY, PARKER, PERKINS,
  SERRANO, TKACZYK -- read twice and ordered printed, and  when  printed
  to  be committed to the Committee on Health -- reported favorably from
  said committee and committed to the Committee on Finance  --  reported
  favorably  from  said  committee,  ordered to first and second report,
  amended on second report, ordered  to  a  third  reading,  and  to  be
  reprinted  as amended, retaining its place in the order of third read-
  ing -- again amended and ordered reprinted, retaining its place in the
  order of third reading

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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD14648-10-4

S. 7234--B                          2

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,
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
DEPARTMENT'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

S. 7234--B                          3

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.  TO  THE  EXTENT  A  POLICY
PROVIDES  COVERAGE FOR MATERNAL DEPRESSION SCREENING, 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,  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  ACCESS  TO  SUCH  SERVICES,  COVERAGE  AND CHOICE OF
PROVIDER IS OTHERWISE SUBJECT TO THE TERMS AND CONDITIONS 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. TO  THE  EXTENT  A  CONTRACT
PROVIDES  COVERAGE  FOR  MATERNAL  DEPRESSION  SCREENING, 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 ACCESS TO SUCH SERVICES, COVERAGE AND CHOICE
OF PROVIDER IS OTHERWISE SUBJECT TO THE  TERMS  AND  CONDITIONS  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.  TO  THE  EXTENT  A  PLAN
PROVIDES  COVERAGE  FOR MATERNAL DEPRESSION SCREENING, NO HEALTH MAINTE-
NANCE ORGANIZATION SUBJECT TO THIS ARTICLE SHALL  BY  CONTRACT,  WRITTEN
POLICY  OR PROCEDURE LIMIT A PATIENT ENROLLEE'S DIRECT ACCESS TO SCREEN-
ING 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 ENROLLEE'S ACCESS TO SUCH SERVICES, COVERAGE AND CHOICE
OF PROVIDER IS OTHERWISE 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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