HR 20
110th CONGRESS
1st Session
H. R. 20
IN THE SENATE OF THE UNITED STATES
October 16, 2007
Received; read twice and referred to the Committee on Health, Education,
Labor, and Pensions
AN ACT
To provide for research on, and services for individuals with,
postpartum depression and psychosis.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Melanie Blocker-Stokes Postpartum Depression
Research and Care Act'.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Postpartum depression is a devastating mood disorder which strikes
many women during and after pregnancy.
(2) Postpartum mood changes are common and can be broken into three
subgroups: `baby blues', which is an extremely common and the less severe
form of postpartum depression; postpartum mood and anxiety disorders,
which are more severe than baby blues and can occur during pregnancy
and anytime within the first year of the infant's birth; and postpartum
psychosis, which is the most extreme form of postpartum depression and
can occur during pregnancy and up to 12 months after delivery.
(3) `Baby blues' is characterized by mood swings, feelings of being
overwhelmed, tearfulness, irritability, poor sleep, mood changes, and
a sense of vulnerability.
(4) The symptoms of postpartum mood and anxiety disorders are the worsening
and the continuation of the baby blues beyond the first days or weeks
after delivery.
(5) The symptoms of postpartum psychosis include losing touch with reality,
distorted thinking, delusions, auditory hallucinations, paranoia, hyperactivity,
and rapid speech or mania.
(6) Each year over 400,000 women suffer from postpartum mood changes,
with baby blues afflicting up to 80 percent of new mothers; postpartum
mood and anxiety disorders impairing around 10 to 20 percent of new
mothers; and postpartum psychosis striking 1 in 1,000 new mothers.
(7) Postpartum depression is a treatable disorder if promptly diagnosed
by a trained provider and attended to with a personalized regimen of
care including social support, therapy, medication, and when necessary
hospitalization.
(8) All too often postpartum depression goes undiagnosed or untreated
due to the social stigma surrounding depression and mental illness,
the myth of motherhood, the new mother's inability to self-diagnose
her condition, the new mother's shame or embarrassment over discussing
her depression so near to the birth of her child, the lack of understanding
in society and the medical community of the complexity of postpartum
depression, and economic pressures placed on hospitals and providers.
(9) Untreated, postpartum depression can lead to further depression,
substance abuse, loss of employment, divorce and further social alienation,
self-destructive behavior, or even suicide.
(10) Untreated, postpartum depression impacts society through its effect
on the infant's physical and psychological development, child abuse,
neglect, or death of the infant or other siblings, and the disruption
of the family.
TITLE I--RESEARCH ON POSTPARTUM DEPRESSION AND PSYCHOSIS
SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVITIES.
(a) In General- The Secretary of Health and Human Services, acting through
the Director of the National Institutes of Health and the Director of
the National Institute of Mental Health (in this title referred to as
the `Institute'), is encouraged to continue aggressive work on postpartum
depression and postpartum psychosis.
(b) Coordination With Other Institutes- The Director of the Institute
should continue to coordinate activities of the Director under subsection
(a) with similar activities conducted by the other national research institutes
and agencies of the National Institutes of Health to the extent that such
Institutes and agencies have responsibilities that are related to postpartum
conditions.
(c) Programs for Postpartum Conditions- In carrying out subsection (a),
the Director of the Institute is encouraged to continue research to expand
the understanding of the causes of, and to find a cure for, postpartum
conditions. Activities under such subsection shall include conducting
and supporting the following:
(1) Basic research concerning the etiology and causes of the conditions.
(2) Epidemiological studies to address the frequency and natural history
of the conditions and the differences among racial and ethnic groups
with respect to the conditions.
(3) The development of improved screening and diagnostic techniques.
(4) Clinical research for the development and evaluation of new treatments,
including new biological agents.
(5) Information and education programs for health care professionals
and the public.
SEC. 102. NATIONAL PUBLIC AWARENESS CAMPAIGN.
(a) In General- The Director of the National Institutes of Health and
the Administrator of the Health Resources and Services Administration
are encouraged to carry out a coordinated national campaign to increase
the awareness and knowledge of postpartum depression and postpartum psychosis.
(b) Public Service Announcements- Activities under the national campaign
under subsection (a) may include public service announcements through
television, radio, and other means.
SEC. 103. BIENNIAL REPORTING.
Section 403(a)(5) of the Public Health Service Act (42 U.S.C. 283(a)(5))
is amended--
(1) by redesignating subparagraph (L) as subparagraph (M); and
(2) by inserting after subparagraph (K) the following:
SEC. 104. LONGITUDINAL STUDY OF RELATIVE MENTAL HEALTH CONSEQUENCES
FOR WOMEN OF RESOLVING A PREGNANCY.
(a) Sense of Congress- It is the sense of Congress that the Director of
the Institute may conduct a nationally representative longitudinal study
(during the period of fiscal years 2008 through 2018) of the relative
mental health consequences for women of resolving a pregnancy (intended
and unintended) in various ways, including carrying the pregnancy to term
and parenting the child, carrying the pregnancy to term and placing the
child for adoption, miscarriage, and having an abortion. This study may
assess the incidence, timing, magnitude, and duration of the immediate
and long-term mental health consequences (positive or negative) of these
pregnancy outcomes.
(b) Report- Beginning not later than 3 years after the date of the enactment
of this Act, and periodically thereafter for the duration of the study
under subsection (a), the Director of the Institute should prepare and
submit to the Congress reports on the findings of the study.
TITLE II--DELIVERY OF SERVICES REGARDING POSTPARTUM DEPRESSION AND PSYCHOSIS
SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS.
(a) In General- The Secretary of Health and Human Services (in this title
referred to as the `Secretary') should in accordance with this title make
grants to provide for projects for the establishment, operation, and coordination
of effective and cost-efficient systems for the delivery of essential
services to individuals with postpartum depression or postpartum psychosis
(referred to in this section as a `postpartum condition') and their families.
(b) Recipients of Grants- A grant under subsection (a) may be made to
an entity only if the entity is a public or nonprofit private entity,
which may include a State or local government; a public or nonprofit private
hospital, community-based organization, hospice, ambulatory care facility,
community health center, migrant health center, or homeless health center;
or any other appropriate public or nonprofit private entity.
(c) Certain Activities- To the extent practicable and appropriate, the
Secretary shall ensure that projects under subsection (a) provide services
for the diagnosis and management of postpartum conditions. Activities
that the Secretary may authorize for such projects may also include the
following:
(1) Delivering or enhancing outpatient and home-based health and support
services, including case management, screening, and comprehensive treatment
services for individuals with or at risk for postpartum conditions;
and delivering or enhancing support services for their families.
(2) Delivering or enhancing inpatient care management services that
ensure the well-being of the mother and family and the future development
of the infant.
(3) Improving the quality, availability, and organization of health
care and support services (including transportation services, attendant
care, homemaker services, day or respite care, and providing counseling
on financial assistance and insurance) for individuals with postpartum
conditions and support services for their families.
(d) Integration With Other Programs- To the extent practicable and appropriate,
the Secretary should integrate the program under this title with other
grant programs carried out by the Secretary, including the program under
section 330 of the Public Health Service Act.
SEC. 202. CERTAIN REQUIREMENTS.
A grant may be made under section 201 only if the applicant involved makes
the following agreements:
(1) Not more than 5 percent of the grant will be used for administration,
accounting, reporting, and program oversight functions.
(2) The grant will be used to supplement and not supplant funds from
other sources related to the treatment of postpartum conditions.
(3) The applicant will abide by any limitations deemed appropriate by
the Secretary on any charges to individuals receiving services pursuant
to the grant. As deemed appropriate by the Secretary, such limitations
on charges may vary based on the financial circumstances of the individual
receiving services.
(4) The grant will not be expended to make payment for services authorized
under section 201(a) to the extent that payment has been made, or can
reasonably be expected to be made, with respect to such services--
(A) under any State compensation program, under an insurance policy,
or under any Federal or State health benefits program; or
(B) by an entity that provides health services on a prepaid basis.
(5) The applicant will, at each site at which the applicant provides
services under section 201(a), post a conspicuous notice informing individuals
who receive the services of any Federal policies that apply to the applicant
with respect to the imposition of charges on such individuals.
SEC. 203. TECHNICAL ASSISTANCE.
The Secretary may provide technical assistance to assist entities in complying
with the requirements of this title in order to make such entities eligible
to receive grants under section 201.
TITLE III--GENERAL PROVISIONS
SEC. 301. AUTHORIZATION OF APPROPRIATIONS.
To carry out this Act and the amendments made by this Act, there are authorized
to be appropriated--
(1) $3,000,000 for fiscal year 2008; and
(2) such sums as may be necessary for fiscal years 2009 and 2010.
Passed the House of Representatives October 15, 2007.
Attest:
LORRAINE C. MILLER,
Clerk.
END
