[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3529 Introduced in Senate (IS)]








109th CONGRESS
  2d Session
                                S. 3529

   To ensure that new mothers and their families are educated about 
    postpartum depression, screened for symptoms, and provided with 
essential services, and to increase research at the National Institutes 
                  of Health on postpartum depression.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 15, 2006

  Mr. Menendez (for himself and Mr. Durbin) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To ensure that new mothers and their families are educated about 
    postpartum depression, screened for symptoms, and provided with 
essential services, and to increase research at the National Institutes 
                  of Health on postpartum depression.

    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 ``Mom's Opportunity to Access Health, 
Education, Research, and Support for Postpartum Depression Act'' or the 
``MOTHERS 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 that usually 
        starts in the first week and resolves without treatment by the 
        end of the second week postpartum.
            (4) The symptoms of postpartum mood and anxiety disorders 
        are as defined in the latest edition of Diagnostic and 
        Statistical Manual of Mental Disorders (DSM), as published by 
        American Psychological Association.
            (5) The symptoms of postpartum psychosis include losing 
        touch with reality, distorted thinking, delusions, auditory 
        hallucinations, paranoia, hyperactivity, and rapid speech or 
        mania.
            (6) Baby blues afflicts up to 80 percent of new mothers, 
        postpartum depression occurs in 10 to 20 percent of new 
        mothers, and postpartum psychosis strikes 1 in 1,000 new 
        mothers.
            (7) The causes of postpartum depression are complex and 
        unknown at this time; however, contributing factors 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 romanticization 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 effect on the infant's physical and psychological 
        and cognitive development, child abuse, neglect or death of the 
        infant or other siblings, and the disruption of the family.
            (12) This Act shares the goals of the Melanie Blocker-
        Stokes Postpartum Depression Research and Care Act and will 
        help new mothers who are battling with postpartum conditions.

   TITLE I--DELIVERY OF SERVICES REGARDING POSTPARTUM DEPRESSION AND 
                               PSYCHOSIS

SEC. 101. DELIVERY OF SERVICES REGARDING POSTPARTUM DEPRESSION AND 
              PSYCHOSIS.

    Subpart 3 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb-31 et seq.) is amended--
            (1) by inserting after the subpart heading the following:

                   ``CHAPTER I--GENERAL PROVISIONS'';

            and
            (2) by adding at the end thereof the following:

``CHAPTER II--DELIVERY OF SERVICES REGARDING POSTPARTUM DEPRESSION AND 
                               PSYCHOSIS

``SEC. 520K. ESTABLISHMENT OF PROGRAM OF GRANTS.

    ``(a) In General.--The Secretary shall in accordance with this 
chapter make grants to provide for projects for the establishment, 
operation, and coordination of effective and cost-efficient systems 
to--
            ``(1) provide education to women who have recently given 
        birth, and their families, concerning postpartum depression, 
        postpartum mood and anxiety disorders, and postpartum psychosis 
        (referred to in this chapter as `postpartum conditions') before 
        such women leave their birthing centers and to screen new 
        mothers for postpartum conditions during their first year of 
        postnatal checkup visits, including the standard 6-week 
        postnatal checkup visit; and
            ``(2) provide for the delivery of essential services to 
        individuals with postpartum conditions and their families.
    ``(b) Recipients of Grants.--A grant under subsection (a) may be 
made to an entity only if the entity--
            ``(1) is--
                    ``(A) in the case of a grant to carry out the 
                activities described in subsection (c)(1), a State; and
                    ``(B) in the case of a grant to carry out the 
                activities described in subsection (c)(2), 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, tribal government or territory, 
                or homeless health center; or other appropriate public 
                or nonprofit private entity; and
            ``(2) submits to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Certain Activities.--
            ``(1) Education.--
                    ``(A) In general.--To the extent practicable and 
                appropriate, the Secretary shall ensure that projects 
                under subsection (a)(1) develop policies and procedures 
                to ensure that education concerning postpartum 
                conditions is provided to women in accordance with 
                subparagraph (B), that training programs regarding such 
                education are carried out at health facilities within 
                the State, and that screening and referral is provided 
                in accordance with subparagraph (C).
                    ``(B) Requirements.--A State that receives a grant 
                or contract under subsection (a)(1) shall ensure that 
                postpartum condition education complies with the 
                following:
                            ``(i) Physicians, certified nurse midwives, 
                        certified midwives, nurses, and other licensed 
                        health care professionals within the State who 
                        provide prenatal and postnatal care to women 
                        shall also provide education to women and their 
                        families concerning postpartum conditions to 
                        promote earlier diagnosis and treatment.
                            ``(ii) All birthing facilities in the State 
                        shall provide new mothers and fathers, and 
                        other family members as appropriate, with 
                        complete information concerning postpartum 
                        conditions, including its symptoms, methods of 
                        coping with the illness, and treatment 
                        resources prior to such mothers leaving the 
                        birthing facility after a birth.
                            ``(iii) Physicians, certified nurse 
                        midwives, certified midwives, nurses, and other 
                        licensed health care professionals within the 
                        State who provide prenatal and postnatal care 
                        to women shall include fathers and other family 
                        members, as appropriate, in both the education 
                        and treatment processes to help them better 
                        understand the nature and causes of postpartum 
                        conditions.
                    ``(C) Screening and referral.--A State that 
                receives a grant or contract under subsection (a)(1) 
                shall ensure that new mothers, during visits to a 
                physician, certified nurse midwife, certified midwife, 
                nurse, or licensed healthcare professional who is 
                licensed or certified by the State, within the first 
                year after the birth of their child, are offered 
                screenings for postpartum conditions by using the 
                Edinburgh Postnatal Depression Scale (EPDS), or other 
                appropriate tests. If the results of such screening 
                provide warning signs for postpartum conditions, the 
                new mother shall be referred to an appropriate mental 
                healthcare provider.
                    ``(D) Subgrants.--A State that receives a grant or 
                contract under subsection (a)(1) to carry out 
                activities under this paragraph may award subgrants to 
                entities described in subsection (b)(1)(B) to enable 
                such entities to provide education of this type 
                described in subparagraph (B).
            ``(2) Services.--To the extent practicable and appropriate, 
        the Secretary shall ensure that projects under subsection 
        (a)(2) provide services for the diagnosis and management of 
        postpartum conditions. Activities that the Secretary may 
        authorize for such projects may also include the following:
                    ``(A) 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.
                    ``(B) Delivering or enhancing inpatient care 
                management services that ensure the well being of the 
                mother and family and the future development of the 
                infant.
                    ``(C) 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.

``SEC. 520L. TECHNICAL ASSISTANCE.

    ``The Secretary may provide technical assistance to assist entities 
in complying with the requirements of this chapter in order to make 
such entities eligible to receive grants under section 520K.

``SEC. 520M. AUTHORIZATION OF APPROPRIATIONS.

    ``For the purpose of carrying out this chapter, there are 
authorized to be appropriated such sums as may be necessary for each of 
the fiscal years 2007 through 2009.''.

       TITLE II--RESEARCH ON POSTPARTUM DEPRESSION AND PSYCHOSIS

SEC. 201. CONSENSUS RESEARCH CONFERENCE AND PLAN CONCERNING POSTPARTUM 
              DEPRESSION AND PSYCHOSIS.

    Part B of title IV of the Public Health Service Act (42 U.S.C. 284 
et seq.) is amended by adding at the end the following:

``SEC. 409J. CONSENSUS RESEARCH CONFERENCE AND PLAN CONCERNING 
              POSTPARTUM DEPRESSION AND PSYCHOSIS.

    ``(a) Consensus Research Conference and Plan.--
            ``(1) Conference.--The Secretary, acting through the 
        Director of NIH, the Administrator of the Substance Abuse and 
        Mental Health Services Administration, and the heads of other 
        Federal agencies that administer Federal health programs 
        including the Centers for Disease Control and Prevention, shall 
        organize a series of national meetings that are designed to 
        develop a research plan for postpartum depression and psychosis 
        (referred to in this section as `postpartum condition').
            ``(2) Plan.--The Secretary, taking into account the 
        findings of the research conference under paragraph (1), shall 
        develop a research plan relating to postpartum conditions. Such 
        plan shall include--
                    ``(A) basic research concerning the etiology and 
                causes of postpartum conditions;
                    ``(B) epidemiological studies to address the 
                frequency and natural history of postpartum conditions 
                and the differences among racial and ethnic groups with 
                respect to such conditions;
                    ``(C) the development of improved diagnostic 
                techniques relating to postpartum conditions; and
                    ``(D) clinical research for the development and 
                evaluation of new treatments for postpartum conditions, 
                including new biological agents.
            ``(3) Report.--Not later than 2 years after the date of 
        enactment of this section, the Secretary shall prepare and 
        submit to the appropriate committees of Congress a report 
        concerning the research plan under paragraph (2).
    ``(b) Activity Relating to Research Plan.--
            ``(1) In general.--After the development of the research 
        plan under subsection (a)(1), the Secretary, acting through the 
        Director of NIH shall expand and intensify research and related 
        activities of the Institutes relating to postpartum conditions 
        in a manner appropriate to carry out such plan, and in 
        particular shall direct research efforts to carry out such 
        plan.
            ``(2) Report.--Not later than 1 year after the development 
        of the research plan under subsection (a)(1), and annually 
        thereafter, the Secretary shall prepare and submit to the 
        appropriate committees of Congress a report on the progress 
        made with respect to such plan and the status of ongoing 
        activities regarding postpartum conditions at the National 
        Institutes of Health.''.
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