Legislation

This page has information about National and State Legislative action related to perinatal mood disorders and maternal mental health. If you would like us to add or update information from your state, province, or country, please write to us at wdavis@postpartum.net


U.S. National Legislative Action

The Melanie Blocker Stokes MOTHERS Act.

The Melanie Blocker Stokes MOTHERS Act, sponsored by Senators Menendez, Durbin and Snowe, will help provide support services to women suffering from postpartum depression and psychosis and will also help educate mothers and their families about these conditions. In addition, it will support research into the causes, diagnoses and treatments for postpartum depression and psychosis.

The MOTHERS ACT stands for The Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act. 

Read a summary of the Bill HERE
Read the whole text of the Bill HERE

Audio Post Explains the MOTHERS ACT
January 8, 2010

Click RIGHT HERE to link directly to an informative audio broadcast that describes the basic initiatives of The Melanie Blocker Stokes MOTHERS Act. The post does a great job of explaining that the bill does not mandate screening or medication but education, research, and support for pregnant and postpartum women.

This new audio post includes interviews with Dr. Michael Petriella, OB/GYN from Hackensack University Medical Center, Celeste Andriot Wood, Assistant Commissioner, NJ Family Health Services, and Susan Stone, LCSW. The broadcast originally aired on the nationally syndicated program Radio Health Journal in December 2009, and was produced by MediaTracks Communications.

MOTHERS ACT passes Senate version of Healthcare Reform
January 7, 2010

Written by Susan Dowd Stone, MSW, LCSW
Chair, President’s Advisory Council, Postpartum Support International


The MOTHERS Act now passed in Senate version of Healthcare Reform thanks to the efforts of U.S. Senator Robert Menendez! Hallelujah!!! Here is some great news to truly validate our combined efforts and the hopes of THOUSANDS who have never waivered in their support!!!

We are THAT MUCH CLOSER to our goal of better understanding and protecting America’s mothers from postpartum related mood disorders thanks to the incredible focus of U.S Senator Robert Menendez. That much closer to ensuring that the tragedies of untreated maternal mood disorders will cease to devastate American mothers, infants and families.

The MOTHERS Act has been successfully included and passed in the Senate version of The Patient Protection and Affordable Care Act !

The Senator’s office will now continue to work closely with House advocates to ensure it remains in the reconciled version of the bill which will then be presented to Congress for final passage.

But neither these initiatives would not be receiving such public and legislative support were it not for early groundbreaking efforts in the House and Senate to promote postpartum depression research and education.

Congressman Bobby L. Rush has long been a champion of PPD research and education since moved by the plight of his constituent Melanie Blocker Stokes.

Melanie, a beautiful, intelligent mother of a young child with every reason to live, leapt to her death as a result of untreated postpartum illness. Her mother Carol Blocker has waged a tireless campaign to end ignorance. These early champions including Richard and Mary Jo Codey, who dared to look such darkness in the face helped create the initial public platform that led to laws in IL and NJ demanding more attention to postpartum mental health issues.

If you are interested in reading the bill’s specific language, you can go to this link and click on “Full Text of Bill as Passed”. The language referencing The MOTHERS Act initiatives can be found on pages 595-604, section 2952 “Support Education and Research for Postpartum Depression”.

As The MOTHERS Act has always enjoyed great and nearly unanimous support in the U.S. House of Representatives, there is every reason to assume a successful outcome as the bills merge for final consideration and passage. Now is a great time to add your name to the petition to amplify the deafening drumbeat of support as our position strengthens!

Individual listings of constituents from every state who support this bill offer additional personal testimony to the science that substantiates the devastation of untreated maternal depression. Show your state representatives that you are among those who understand the bill’s critical importance to American families!

The days of decreasing the stigma of maternal mental illness long borne by silent suffering mothers and increasing the life saving awareness and services so desperately needed seem imminent.

 

 U.S. State Legislation

If you have legislative news, corrections, or questions from your state, write to PSI Program Director Wendy Davis at wdavis@postpartum.net

California

On April 22, 2010 California Assemblymember Pedro Nava announced that his Assembly Concurrent Resolution 105, sponsored by the Junior Leagues of California State Public Affairs Committee and supported by the Los Angeles County Board of Supervisors, passed the State Assembly on an overwhelming bipartisan vote of 72 to 0. Read Whole Resolution Text

“The State Assembly sent a resounding message today to women and their families—that Perinatal Mood and Anxiety Disorders (PMAD) are a serious health issue and need to be taken seriously. My resolution will raise awareness in California regarding PMAD for new mothers and their families,” said Nava. “These disorders impact 1 in 8 women. By naming the month of May as Perninatal Depression Awareness Month, I hope to facilitate public discussion, increased awareness, and access for women and their families to important healthcare services.”

ACR 105 will proclaim the month of May every year as Perinatal Depression Awareness Month and requests that the State Department of Health Care Services, the State Department of Public Health, the State Department of Mental Health, First 5 California, Postpartum Support International, and other stakeholders work together to explore ways to improve women's access to mental health care at the state and local levels. Additionally, it encourages the stakeholders to facilitate increased awareness and education about perinatal depression and to explore and encourage the use of prenatal screening tools in order to improve the availability of effective treatment and community support services.

Said Los Angeles County Supervisor and Chairwoman, Gloria Molina, “In Los Angeles County, statistics show that perinatal depression and related mood disorders affect almost 20 percent of new and expectant mothers. Assemblymember Nava’s measure is a step in the right direction to make sure that women and their families know that there are supportive healthcare services in Los Angeles County available to them.”

Perinatal mood and anxiety disorders occur during pregnancy as well as during the postpartum period. These disorders can take many forms, including depression, anxiety disorders, and psychosis. The afflictions can have potentially serious repercussions for the emotional, social, and physical health and well-being of mothers, children, and families. National studies indicate that 1 in 8 women suffer from perinatal mood and anxiety disorders and 80% of these women go undiagnosed and untreated.

Said Julie Elginer, Co-Chair of the Junior Leagues of California State Public Affairs Committee and Doctoral Candidate at UCLA School of Public Health, “It is with tremendous pride that the Junior Leagues of California continues our two-year collaboration with Assembly Member Nava, advocating on behalf of women and their families who are affected by perinatal depression mood and anxiety disorders.

Maternal depression is a widespread public health issue that impacts the well-being and livelihood of mothers, their children, and their families. In California, there are nearly 550,000 new and expectant mothers annually. The month-long designation allows stakeholders including mental and public health departments, healthcare providers, community and faith based organizations, support groups, and other nonprofits a consistent opportunity to coordinate resources, work to increase awareness, and educate their local communities as to the services available to women, infants, children and families.
ACR 105 will next go to the Secretary of State for Chaptering.

Illinois

Senate Bill 15 in 2007 created the “Postpartum Mood Disorders Prevention Act.” It became law in 2008. It calls for early screening of postpartum depression by front-line health workers such as pediatricians, primary care doctors, nurse practitioners and obstetricians. Medicaid covers PPD screenings and treatment. Screening for perinatal depression using an approved instrument is reimbursable for women enrolled in health care and family services, from pregnancy through one year after delivery. If women are screened by a provider during their infant’s well-child and episodic visits, the screening can be reimbursed through the infant’s coverage. Infants and toddlers of mothers with mental health diagnoses (including depression) are automatically eligible for the early intervention program.

Through a contract with its managed care organizations and its primary care case management network, Illinois requires prenatal and postpartum depression screening using an approved validated, standardized tool, referral, and treatment, as well as ongoing monitoring and tracking for enrollees. A complementary state law requires that women and their families be educated about perinatal mental health disorders in prenatal and labor and delivery settings, and that women be invited to take an assessment questionnaire in prenatal, postnatal, and pediatric care settings.

The Perinatal Mental Health Consultation Service operated by the University of Illinois at Chicago, and the state, in partnership with the Illinois Chapter of the Academy of Pediatrics and the Academy of Family Physicians offers provider consultative services and education and training to clinicians across disciplines to develop competencies in assessment and treatment of maternal depression. The education and quality improvement initiatives also include a pilot to develop a stepped care model; it includes self-care kits to be disseminated statewide that provide information on when and where to access resources. The state is also piloting a tool to assess risk at the preconception and interconception stages. The initiative also includes support for postpartum depression crisis intervention through hotlines.

Iowa

In Iowa, the Department of Public Health is working to improve provider knowledge and capacity as well as consumer knowledge and ease of access. The Iowa Perinatal Depression Project has expanded screening, early identification, and effective treatment referrals for perinatal depression. The project is housed within the Bureau of Family Health within the Division of Health Promotion and Chronic Disease Prevention of the Iowa Department of Public Health.

In collaboration with three other state departments, a statewide advocacy organization and the University of Iowa sponsor a statewide train-the-trainer program that to date has trained an estimated 100 trainers. The program trains program staff in early childhood, maternal health, case management, and mental health programs, as well as Special Supplemental Nutrition Program for Women, Infants, and Children or WIC, nursing, and home visiting staff. It includes a mentorship component, requires agency-level commitment to screening, and reimburses agencies for staff time.

In collaboration with the University of Iowa, the state has developed a web-based training for physicians known as STEP, Support and Train to Enhance Primary Care. It contains a consultation component and is designed to enhance the state’s capacity in primary care to appropriately identify and treat perinatal depression.

The state also produced a pocket guide for health care professionals, that is, a reference book that includes information on treatment, coding, and billing. It is anticipated that this will be widely distributed through the major health care provider associations.

Iowa also established a provider and consumer website providing referral information that identifies mental health providers in all 99 counties, details of payment requirements and their specific training in perinatal depression. Primary care providers who access this service can also get free consultation with a University of Iowa–based mental health clinician. To improve screening, the state added two depression screening questions (from the Patient Health Questionnaire, a standardized assessment) to the Department of Human Services– approved Prenatal Risk Assessment tool required for all providers. The state funds a toll-free telephone resource and referral information line.

 

Kentucky

The Kentucky Health Access Nurturing Development Services (H.A.N.D.S.) Reach Out about Perinatal Depression Project, housed in the Kentucky Department of Public Health, is increasing awareness among health care providers and the general public about perinatal depression. This project runs a home visiting program that promotes a supportive and healthy environment for mothers and their newborns. Home visitors are trained through the Madison County Health Department and the University of Louisville. The project has also developed a stepped-care protocol for referral and treatment of women depending on their scores on a self-administered perinatal depression screening tool.

 

Louisiana

The Louisiana Perinatal Depression Project, through the Louisiana Department of Health and Hospitals, is tackling the unique challenge of caring for women with perinatal depression in the ravaged post-Hurricane Katrina environment. This project has provided mental health treatment and case management to women, infants and their support partners in metropolitan New Orleans. The project trains providers about perinatal depression and infant mental health.

 

Massachusetts

Chapter 313 of the Acts of 2010, An Act Relative to Postpartum Depression, calls on the state’s Department of Public Health (DPH) to develop standards for effective PPD screening, and regulations for providers and health plans to report on PPD screening. The law also created a special PPD Commission, made up of legislators, members of the administration, health care professionals, insurance representatives, nonprofit groups, survivors and others to develop recommendations about addressing PPD statewide, and provide guidance to DPH, the Governor and other government bodies on the issue.

 

Maine

LD 792/SP 241, February 2007, this bill provides information on and screening for prenatal and postpartum mental health issues to pregnant women and mothers of children under one year of age and information to the partners, spouses or fathers and family members, as appropriate.

Minnesota

Minnesota passed a Postpartum Depression Education & Information Bill (S.F. 2278) in 2006 that requires that all providers of prenatal care must have information about PPD availabe to pregnant women and their families, and that hospitals and other health care facilities must provide new mothers and their families with written information about PPD. The bill included both statutory requirements (as above) and also best-practice guidelines for where and when information ought to be offered.
Read the bill at the MN Dept of Health website HERE

New Jersey

In 2006, New Jersey S213 was signed into law by New Jersey Governor Jon Corzine (D). This law, known as the Postpartum Depression Law, was introduced by State Senate President Richard Codey inspired by his wife, PPD Advocate Mary Jo Codey, and is known for being the first in the United States to require healthcare providers/facilities to screen women who have recently given birth for postpartum depression and to educate women and families. A budget of $4.5 million was provided for a comprehensive program, including the establishment of a statewide perinatal mental health referral network. The program is called "Speak Up When You're Down”.  Read more HERE

Oregon

In 2009 Oregon passed House Bill 2666, creating a statewide workgroup on maternal mental health disorders within the Department of Human Services. The workgroup includes representatives from families, early childhood and maternal care providers, and will address vulnerable populations across the state. HB 2666 will identify successful projects implemented in Oregon and other states and recommend programs, tools, and funding sources to initiate needed projects. It will make a report to the legislature identifying actions to be taken by 2015 to reduce the risk of harm to women and their children. In January 2010, Rep. Tomei will introduce a resolution to designate every May as Maternal Mental Health Awareness Month in Oregon and to encourage the Oregon Early Childhood Council, health care providers, would-be parents and other stakeholders to address the mental health needs of pregnant and postpartum women and their families. Carolyn Tomei (D-Milwaukie), lead sponsor of the bills, reached out to Oregonians active in the maternal mental health field and together formed a committee that wrote this two-part legislative proposal. Read the Statewide Workgroup Bill HB2666 HERE.

West Virginia

H.B. 4052, Uniform Maternal Screening Bill was introduced on January 2008, and passed April 2009 as SB307. It requires that women upon entering prenatal care would undergo the prenatal risk screening instrument. The bill created the Maternal Risk Screening Advisory.

Texas

HB3318, potentially the first infanticide law in the United States, was introduced in 2009 by Representative Jessica Farrar (D-Houston) and would apply to women who commit the crime within 12 months of giving birth. If jurors find a defendant guilty of murder, they can take testimony about postpartum issues into consideration during the trial's punishment phase.
Read the bill HERE

Virginia

In 2003, House Bill 2310 required all hospital staff (nurses, doctors, etc) to distribute perinatal depression statistics and materials. 

Washington

In 2005, SB 5898 and HB 1427 ordered a public information campaign on postpartum depression, and mandated that the council would conduct a proactive, public information and communication outreach campaign concerning the significance, signs, and treatment of postpartum depression. The "Speak Up When You're Down" campaign was created and implemented as a result of this law. 

Visit the Perinatal Depression Information Network website for more information about state legislation and initiatives. 

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