[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 846 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 846

    To provide for research on, and services for individuals with, 
                  postpartum depression and psychosis.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 13, 2003

 Mr. Rush (for himself, Mrs. Jones of Ohio, Mr. Gutierrez, Ms. Kaptur, 
 Ms. Schakowsky, Mr. Towns, Mr. Fattah, Ms. Lee, Mr. Payne, Mr. Owens, 
  Mr. McDermott, Mr. Waxman, Mrs. Maloney, Mrs. Capps, Mr. Jackson of 
Illinois, Ms. Jackson-Lee of Texas, Ms. Millender-McDonald, Mr. Olver, 
   Mr. Engel, Ms. Woolsey, Mr. Hinchey, Mrs. Christensen, Mr. George 
Miller of California, Mr. Israel, Mr. Kildee, Ms. McCarthy of Missouri, 
Mr. Wynn, Mr. Conyers, Ms. Carson of Indiana, Ms. Norton, Mr. Boehlert, 
  Mr. Cummings, Ms. Harman, Mr. Holden, Mr. Dingell, Mr. McNulty, Mr. 
Case, Mr. Costello, Mr. Davis of Illinois, Mr. Stark, Mr. Tierney, Ms. 
DeLauro, Mr. Etheridge, Mr. Nadler, Mr. Lantos, Mr. Watt, Mrs. Biggert, 
     Mr. Bishop of Georgia, Mr. LaHood, and Mr. Moran of Virginia) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
    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 twelve 
        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 10-20 percent of new mothers; and postpartum psychosis 
        striking 1 in 1,000 new mothers.
            (7) The causes of postpartum depression are complex and 
        unknown at this time; however, theories include a steep and 
        rapid drop in hormone levels after childbirth; difficulty 
        during labor or pregnancy; a premature birth; a miscarriage; 
        feeling overwhelmed, uncertain, frustrated or anxious about 
        one's new role as a mother; a lack of support from one's 
        spouse, friends or family; marital strife; stressful events in 
        life such as death of a loved one, financial problems, or 
        physical or mental abuse; a family history of depression or 
        mood disorders; a previous history of major depression or 
        anxiety; or a prior postpartum depression.
            (8) 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.
            (9) 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.
            (10) Untreated, postpartum depression can lead to further 
        depression, substance abuse, loss of employment, divorce and 
        further social alienation, self-destructive behavior, or even 
        suicide.
            (11) Untreated, postpartum depression impacts society 
        through its affect 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 OF NATIONAL 
              INSTITUTE OF MENTAL HEALTH.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Director of NIH and the Director of the National Institute 
of Mental Health (in this section referred to as the ``Institute''), 
shall expand and intensify research and related activities of the 
Institute with respect to postpartum depression and postpartum 
psychosis (in this section referred to as ``postpartum conditions'').
    (b) Coordination With Other Institutes.--The Director of the 
Institute shall coordinate the 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 shall conduct or support 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 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.
    (d) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2004 through 2006.

  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'') shall 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 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 shall 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.

SEC. 204. AUTHORIZATION OF APPROPRIATIONS.

    For the purpose of carrying out this title, there are authorized to 
be appropriated such sums as may be necessary for each of the fiscal 
years 2004 through 2006.
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