Defines perinatal depression, requires the provision of perinatal depression education, and the provision of a screening and data reporting plan for the state

Summary of specific provisions

Section 1 adds a new section 2502-a to the Public Health Law defining perinatal depression and maternal health professional and establishes standards for data reporting on perinatal screening. The bill will ensure that maternal health providers are educated about perinatal depression and trained on screening mothers to administer appropriate diagnostic tools, and manage maternal and perinatal depression. All qualified health professionals shall screen pregnant mothers using standardized tools which shall consist of three screenings in an obstetrical setting and three screenings after bit1h in a pediatric setting. The commissioner shall recommend and provide appropriate standardized, validated diagnostic tools for all perinatal screening. Fathers and other family members shall, as appropriate be included in the education and treatment process for perinatal depression.

Section 2 amends section 207 subdivision (g) of the Public Health Law by adding perinatal depression to the list of healthcare and wellness outreach education that must be done by the Department of Health.

Section 3 amends section 4303 subsection (c) subparagraph (B) of the Insurance Law by adding the reporting of perinatal depression signs to be covered by maternity care coverage.

Section 4 amends section 3217-c subsection (a) of the Insurance Law by adding perinatal depression to the conditions that cannot be limited by coverage.

Section 5 amends section 3216 item (ii) of subparagraph (A) of paragraph 10 of subsection (i) of the Insurance Law by adding perinatal depression to maternity care coverage.

Section 6 amends section 4804 paragraph 1 of subsection (e) and subsection (f) the Insurance Law by continuing ongoing treatment for perinatal depression for 90 days should the insurer leave the network of providers.

Section 7 requires state and private insurers to establish a reimbursement structure for perinatal screenings or follow provisions in section 2530 of the Public Health Law.

Section 8 establishes an effective date.

Justification

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

Depression associated with childbirth is commonly categorized under three types: the "baby blues", postpartum depression, and postpartum psychosis. Postpartum psychosis, the most severe form of perinatal depression, usually includes auditory hallucinations and delusions, and in some cases visual hallucinations.

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 has a five percent suicide rate and four percent rate of infanticide, or death of an infant.

Often, the symptoms of perinatal depression are not immediately identified because they closely resemble those generally associated with pregnancy. As a result, perinatal depression is sometimes left untreated, and ultimately may result in detrimental impact to the entire family. The family is affected in the following ways: children of mothers with perinatal 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; and a mother experiencing depression does not often disclose her condition due to feelings of shame, and so the severity of the condition worsens.

Perinatal depression is often undetected and untreated by health professionals due to both lack of training in identifying the condition, as well as safety concerns about treating pregnant women. Early screening and identification of perinatal depression has an 80 to 90 percent success rate and offers long-term health care costs savings.

Legislative history

New bill.

Fiscal implications

To be determined.

Effective date

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