[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 20 Referred in Senate (RFS)]

  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:
                    ``(L) Depression.''.

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.