[House Report 111-48]
[From the U.S. Government Publishing Office]
111th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 111-48
======================================================================
MELANIE BLOCKER STOKES MOTHERS ACT
_______
March 23, 2009.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Waxman, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 20]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 20) to provide for research on, and services for
individuals with, postpartum depression and psychosis, having
considered the same, report favorably thereon with an amendment
and recommend that the bill as amended do pass.
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Melanie Blocker Stokes Mom's
Opportunity to Access Health, Education, Research, and Support for
Postpartum Depression Act'' or the ``Melanie Blocker Stokes MOTHERS
Act''.
SEC. 2. DEFINITIONS.
For purposes of this Act--
(1) the term ``postpartum condition'' means postpartum
depression or postpartum psychosis; and
(2) the term ``Secretary'' means the Secretary of Health and
Human Services.
TITLE I--RESEARCH ON POSTPARTUM CONDITIONS
SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVITIES.
(a) Continuation of Activities.--The Secretary is encouraged to
continue activities on postpartum conditions.
(b) Programs for Postpartum Conditions.--In carrying out subsection
(a), the Secretary is encouraged to continue research to expand the
understanding of the causes of, and treatments 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.
(5) Information and education programs for health care
professionals and the public, which may include a coordinated
national campaign to increase the awareness and knowledge of
postpartum conditions. Activities under such a national
campaign may--
(A) include public service announcements through
television, radio, and other means; and
(B) focus on--
(i) raising awareness about screening;
(ii) educating new mothers and their families
about postpartum conditions to promote earlier
diagnosis and treatment; and
(iii) ensuring that such education includes
complete information concerning postpartum
conditions, including its symptoms, methods of
coping with the illness, and treatment
resources.
SEC. 102. SENSE OF CONGRESS REGARDING 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 National Institute of Mental Health may conduct a nationally
representative longitudinal study (during the period of fiscal years
2009 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, such Director may prepare and submit to the Congress reports
on the findings of the study.
TITLE II--DELIVERY OF SERVICES REGARDING POSTPARTUM CONDITIONS
SEC. 201. ESTABLISHMENT OF GRANT PROGRAM.
Subpart I of part D of title III of the Public Health Service Act (42
U.S.C. 254b et seq.) is amended by inserting after section 330G the
following:
``SEC. 330G-1. SERVICES TO INDIVIDUALS WITH A POSTPARTUM CONDITION AND
THEIR FAMILIES.
``(a) In General.--The Secretary may make grants to eligible entities
for projects for the establishment, operation, and coordination of
effective and cost-efficient systems for the delivery of essential
services to individuals with a postpartum condition and their families.
``(b) Certain Activities.--To the extent practicable and appropriate,
the Secretary shall ensure that projects funded under subsection (a)
provide education and services with respect to the diagnosis and
management of postpartum conditions. The Secretary may allow such
projects to include the following:
``(1) Delivering or enhancing outpatient and home-based
health and support services, including case management 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 a postpartum condition and
support services for their families.
``(4) Providing education to new mothers and, as appropriate,
their families about postpartum conditions to promote earlier
diagnosis and treatment. Such education may include--
``(A) providing complete information on postpartum
conditions, symptoms, methods of coping with the
illness, and treatment resources; and
``(B) in the case of a grantee that is a State,
hospital, or birthing facility--
``(i) providing education to new mothers and
fathers, and other family members as
appropriate, concerning postpartum conditions
before new mothers leave the health facility;
and
``(ii) ensuring that training programs
regarding such education are carried out at the
health facility.
``(c) Integration With Other Programs.--To the extent practicable and
appropriate, the Secretary may integrate the grant program under this
section with other grant programs carried out by the Secretary,
including the program under section 330.
``(d) Certain Requirements.--A grant may be made under this section
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 subsection (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 funded under subsection (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.
``(6) For each grant period, the applicant will submit to the
Secretary a report that describes how grant funds were used
during such period.
``(e) Technical Assistance.--The Secretary may provide technical
assistance to entities seeking a grant under this section in order to
assist such entities in complying with the requirements of this
section.
``(f) Definitions.--In this section:
``(1) The term `eligible entity' means a public or nonprofit
private entity, which may include a State or local government;
a public or nonprofit private recipient of a grant under
section 330H (relating to the Healthy Start Initiative),
public-private partnership, hospital, community-based
organization, hospice, ambulatory care facility, community
health center, migrant health center, public housing primary
care center, or homeless health center; or any other
appropriate public or nonprofit private entity.
``(2) The term `postpartum condition' means postpartum
depression or postpartum psychosis.''.
TITLE III--GENERAL PROVISIONS
SEC. 301. AUTHORIZATION OF APPROPRIATIONS.
To carry out this Act and the amendment made by section 201, there
are authorized to be appropriated, in addition to such other sums as
may be available for such purpose--
(1) $3,000,000 for fiscal year 2009; and
(2) such sums as may be necessary for fiscal years 2010 and
2011.
SEC. 302. REPORT BY THE SECRETARY.
(a) Study.--The Secretary shall conduct a study on the benefits of
screening for postpartum conditions.
(b) Report.--Not later than 2 years after the date of the enactment
of this Act, the Secretary shall complete the study required by
subsection (a) and submit a report to the Congress on the results of
such study.
SEC. 303. LIMITATION.
Notwithstanding any other provision of this Act or the amendment made
by section 201, the Secretary may not utilize amounts made available
under this Act or such amendment to carry out activities or programs
that are duplicative of activities or programs that are already being
carried out through the Department of Health and Human Services.
CONTENTS
Page
Purpose and Summary.............................................. 4
Background and Need for Legislation.............................. 4
Hearings......................................................... 5
Committee Consideration.......................................... 5
Committee Votes.................................................. 5
Committee Oversight Findings..................................... 5
Statement of General Performance Goals and Objectives............ 6
New Budget Authority, Entitlement Authority, and Tax Expenditures 6
Earmarks and Tax and Tariff Benefits............................. 6
Committee Cost Estimate.......................................... 6
Congressional Budget Office Estimate............................. 6
Federal Mandates Statement....................................... 8
Advisory Committee Statement..................................... 8
Constitutional Authority Statement............................... 8
Applicability to Legislative Branch.............................. 8
Section-by-Section Analysis of the Legislation................... 9
Explanation of Amendments........................................ 10
Changes in Existing Law Made by the Bill, as Reported............ 10
Purpose and Summary
The purpose of H.R. 20, the ``Melanie Blocker Stokes Mom's
Opportunity to Access Health, Education, Research, and Support
for Postpartum Depression Act (the Melanie Blocker Stokes
MOTHERS Act)'', is to provide research on and services for
individuals with postpartum depression and psychosis. The
legislation encourages the Secretary of Health and Human
Services to continue activities and research on postpartum
depression and post-partum psychosis and authorizes the
appropriation of $3 million in FY2009 and such sums as may be
necessary in FY2010 and FY2011 for the Secretary to make grants
to support effective and cost-efficient systems for the
delivery of essential services to individuals with such
conditions.
Background and Need for Legislation
Depression is a very common disorder, affecting 15% to 25%
of the population and representing a yearly economic burden of
$44 billion. Overall, depression is frequently undetected, with
fewer than 25% of patients suffering from mental illness
actually under the care of a mental health specialist.
Depression is twice as common in women as it is in men, with
its peak incidence during the primary reproductive years--ages
25 to 45.
Because women are more likely to experience depression
during these years, they are especially vulnerable to
developing depression during pregnancy and postpartum mental
health disorders after childbirth. In the United States, there
may be as many as 800,000 new cases of postpartum conditions
each year. The spectrum of postpartum mood disorders is
generally divided into three distinct categories, with the
``maternity blues'' or ``baby blues'' at the mildest end of the
spectrum.
Postpartum depression occurs after 10% to 15% of all
deliveries and after 26% to 32% of all adolescent deliveries.
The majority of patients suffer from this illness for more than
6 months and, if untreated, 25% of patients are still depressed
a year later. Women with postpartum depression may feel
restless, anxious, sad, or depressed. They may have feelings of
guilt, decreased energy and motivation, and a sense of
worthlessness. They may also have sleep difficulties and
undergo unexplained weight loss or gain.
The most severe postpartum condition is postpartum
psychosis. A comparatively rare disease, it complicates only
0.1% to 0.2% of deliveries. Symptoms generally present within
the first 4 weeks of postpartum, when the risk of
hospitalization is 22 times greater, but can manifest up to 90
days after delivery. A second smaller peak in incidence is
evident at 18 to 24 months. Patients suffering from postpartum
psychosis are severely impaired, suffering from hallucinations
and delusions that frequently focus on the infant dying or
being divine or demonic. These hallucinations often command
that the patient hurt herself or others, placing these mothers
at the highest risk for committing infanticide and/or suicide.
Hearings
The Committee on Energy and Commerce held a hearing on
legislation similar to H.R. 20 on May 1, 2007, in the 110th
Congress. The Subcommittee heard from two panels of witnesses
and experts. The first panel consisted of testimony by
Catherine Roca, M.D., Chief, Women's Programs, National
Institute of Mental Health, National Institutes of Health. The
second panel had five witnesses: Nada Stotland, M.D., M.P.H.,
Professor of Psychiatry and Obstetrics/Gynecology, Rush Medical
College, Chicago (testifying on behalf of the American
Psychiatric Association); Ms. Mary Jo Codey, Former First Lady
of the State of New Jersey; Ms. Carol Blocker, mother of
Melanie Blocker-Stokes; Priscilla K. Coleman, Ph.D., Associate
Professor of Human Development and Family Studies, Bowling
State University; and Ms. Michaelene Fredenburg, President,
Life Perspectives. The Committee on Energy and Commerce did not
hold hearings on the legislation in the 111th Congress.
Committee Consideration
The Committee on Energy and Commerce met in open markup
session on Wednesday, March 4, 2009, and, pursuant to a motion
by Mr. Waxman, agreed by unanimous consent to consider and
approve H.R. 20 and several other bills en bloc. H.R. 20 was
ordered favorably reported, amended, to the House by a voice
vote. An amendment to H.R. 20 offered by Mr. Waxman was adopted
by unanimous consent.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no recorded votes taken during consideration or
ordering H.R. 20 reported to the House.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Subcommittee on Health has held
legislative hearings on legislation similar to H.R. 20 in the
110th Congress and made oversight findings that are reflected
in this report.
Statement of General Performance Goals and Objectives
H.R. 20 encourages the Secretary of Health and Human
Services to continue activities on postpartum depression and
postpartum psychosis. H.R. 20 encourages the Secretary to
continue research to expand the understanding of the causes of,
and treatments for, such conditions. H.R. 20 states that the
Secretary may make grants to establish, operate, and coordinate
effective and cost-efficient systems for the delivery of
essential services to individuals with such conditions and
their families. This legislation further allows the Secretary
to provide technical assistance to grant recipients.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
20 would result in no new or increased budget authority,
entitlement authority, or tax expenditures.
Earmarks and Tax and Tariff Benefits
In compliance with clause 9 of rule XXI of the Rules of the
House of Representatives, H.R. 20 does not contain any
congressional earmarks, limited tax benefits, or limited tariff
benefits as defined in clause 9(d), 9(e), or 9(f) of rule XXI.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate on
H.R. 20 provided by the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, March 19, 2009.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 20, the Melanie
Blocker Stokes MOTHERS Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Jamease
Kowalczyk.
Sincerely,
Douglas W. Elmendorf,
Director.
Enclosure.
H.R. 20--Melanie Blocker Stokes MOTHERS Act
Summary: H.R. 20 would encourage the Secretary of Health
and Human Services (HHS) to continue ongoing activities at the
National Institutes of Health (NIH) and the Health Resources
and Services Administration (HRSA) related to research and
dissemination of information concerning postpartum depression
or postpartum psychosis. The bill also would direct the
Secretary to provide grants to public or nonprofit entities to
establish and operate programs that provide health care and
support services to individuals with postpartum depression or
postpartum psychosis.
For those purposes, the bill would authorize the
appropriation of $3 million for fiscal year 2009 and such sums
as are necessary for fiscal years 2010 and 2011. CBO estimates
that implementing the bill would cost less than $500,000 in
2009 and about $9 million over the 2009-2014 period, assuming
the appropriation of the necessary amounts. Enacting H.R. 20
would not affect direct spending or revenues.
The bill contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA);
any costs to state and local governments would be incurred
voluntarily.
Estimated cost to the Federal Government: The estimated
budgetary impact of H.R. 20 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
----------------------------------------------------------
2009 2010 2011 2012 2013 2014 2009-2014
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATION
Estimated Authorization Level........................ 3 3 3 0 0 0 9
Estimated Outlays.................................... * 2 3 2 1 0 9
----------------------------------------------------------------------------------------------------------------
Note: = *Less than $500,000.
Basis of estimate: For this estimate, CBO assumes that H.R.
20 will be enacted before August 2009, that the authorized
amounts will be appropriated for each year, and that outlays
will follow historical spending patterns for similar programs.
Grants for services related to postpartum depression and psychosis
H.R. 20 would authorize the Secretary of HHS to make grants
to public or nonprofit entities for the establishment,
operation, and coordination of systems for delivery of services
to individuals with postpartum depression or postpartum
psychosis. Not more than 5 percent of these grants could be
used for administration, accounting, reporting, or program
oversight. These grants would not be permitted to supplant
funds from other sources, including federal and state health
programs.
H.R. 20 would authorize the appropriation of $3 million in
fiscal year 2009 and such sums as are necessary in fiscal years
2010 and 2011. CBO estimates that the $3 million authorized for
appropriation in 2009 would fund a postpartum services grant
program consistent with the requirements of the bill (none of
the $3 million would be required for the research activities
under the bill as described below). CBO estimates that an
additional $3 million a year would be necessary to fund the
grant program in 2010 and 2011. Implementing the grant program
would cost less than $500,000 in 2009 and about $9 million over
the 2009-2014 period.
Research on postpartum depression and psychosis
H.R. 20 would encourage the Secretary of HHS, acting
through the Director of the NIH, to continue research efforts
related to postpartum depression and postpartum psychosis. Such
research includes basic research, epidemiological research, the
development of improved diagnostic techniques, clinical
research, and information and education programs. According to
officials at the NIH, the institutes currently support all of
those activities.
The bill also would encourage the Director of the NIH and
the Administrator of HRSA carry out a national campaign to
raise awareness of postpartum depression. According to
officials at the NIH, the institutes already communicate and
disseminate their research findings as required by law. Both
the NIH and HRSA sponsor Web sites devoted to postpartum
depression. According to officials at HHS, HRSA frequently uses
public service announcements to communicate messages to the
public. CBO estimates that there would be no cost to HRSA to
implement those provisions, because they would not involve any
change in the agency's activities.
Intergovernmental and private-sector impact: H.R. 20
contains no intergovernmental mandates as defined in UMRA.
Grants authorized in the bill would benefit state and local
governments that provide services for diagnosing and managing
postpartum depression. Any costs to those governments to comply
with grant conditions would be incurred voluntarily.
Estimate prepared by: Federal Costs: Jamease Kowalczyk;
Impact on State, Local, and Tribal Governments: Lisa Ramirez-
Branum; Impact on Private Sector: Keisuke Nakagawa.
Estimate approved by: Peter H. Fontaine, Assistant Director
for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by H.R. 20.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
constitutional authority for this legislation is provided in
the provisions of Article I, section 8, clause 1 that relate to
expending funds to provide for the general welfare of the
United States.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 establishes the short title of the Act as the
``Melanie Blocker Stokes MOTHERS Act''.
Section 2. Definitions
Section 2 defines postpartum conditions as postpartum
depression or postpartum psychosis. It also defines
``Secretary'' as the Secretary of Health and Human Services.
TITLE I--RESEARCH ON POSTPARTUM DEPRESSION AND PSYCHOSIS
Title I addresses the activities and research related to
postpartum depression and psychosis.
Section 101 encourages the Secretary to continue activities
on postpartum conditions and to continue research to expand the
understanding of the causes of, and treatments for, these
conditions. These activities include: basic research on the
causes of these conditions; epidemiological studies on the
frequency and history of the conditions as well as differences
among racial and ethnic groups with respect to these
conditions; development of improved screening and diagnostic
techniques; research on new treatments; and information and
education programs for health care professionals and the
public. Information and education programs may include a
coordinated national campaign to increase the awareness and
knowledge of postpartum conditions.
Section 102 is the sense of Congress that the Director of
the National Institute of Mental Health may conduct a
nationally representative longitudinal study (during the period
of fiscal years 2009 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.
TITLE II--DELIVERY OF SERVICES REGARDING POSTPARTUM DEPRESSION AND
PSYCHOSIS
Title II addresses the establishment of grant programs
related to postpartum depression and psychosis.
Section 201 amends Subpart I of part D of title III of the
Public Health Service Act (42 U.S.C. 254b et seq.) to create
section 330G.
Section 330G-1. Services to individuals with a postpartum
condition and their families. Section 330G-1 gives the
Secretary discretionary authority to 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. Recipients of these grants must be either
a public or nonprofit private entity, which may include a state
or local government; a public or nonprofit private recipient of
a grant under section 330H (relating to the Healthy Start
Initiative), public-private partnership, hospital, community-
based organization, hospice, ambulatory care facility,
community health center, migrant health center, public housing
primary care center, or homeless health center; or any other
appropriate public or nonprofit private entity. To the extent
practicable and appropriate, the Secretary may integrate the
grant program under this section with other grant programs
carried out by the Secretary. The Secretary may also provide
technical assistance to entities seeking a grant under this
section in order to assist them in complying with the
requirements of this section.
TITLE III--GENERAL PROVISIONS
Section 301 authorizes $3,000,000 to be appropriated for
fiscal year 2009, and such sums as may be necessary for fiscal
years 2010 and 2011.
Section 302 directs the Secretary to conduct a study on the
benefits for screening for postpartum conditions. The Secretary
is directed to submit the report to Congress no later than two
years after the enactment of this Act.
Section 303 prohibits the Secretary from using any funds
authorized by this legislation to carry out activities or
programs that are duplicative of activities or programs that
are already being carried out through the Department of Health
and Human Services.
Explanation of Amendments
Mr. Waxman offered an amendment that changed the date by
which the Secretary would report findings on the report in
Section 102 from five to three years; and clarified the
categories of entities eligible for grants under Section 201.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italic and existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
Part D--Primary Health Care
Subpart I--Health Centers
* * * * * * *
SEC. 330G-1. SERVICES TO INDIVIDUALS WITH A POSTPARTUM CONDITION AND
THEIR FAMILIES.
(a) In General.--The Secretary may make grants to eligible
entities for projects for the establishment, operation, and
coordination of effective and cost-efficient systems for the
delivery of essential services to individuals with a postpartum
condition and their families.
(b) Certain Activities.--To the extent practicable and
appropriate, the Secretary shall ensure that projects funded
under subsection (a) provide education and services with
respect to the diagnosis and management of postpartum
conditions. The Secretary may allow such projects to include
the following:
(1) Delivering or enhancing outpatient and home-based
health and support services, including case management
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 a postpartum condition and support
services for their families.
(4) Providing education to new mothers and, as
appropriate, their families about postpartum conditions
to promote earlier diagnosis and treatment. Such
education may include--
(A) providing complete information on
postpartum conditions, symptoms, methods of
coping with the illness, and treatment
resources; and
(B) in the case of a grantee that is a State,
hospital, or birthing facility--
(i) providing education to new
mothers and fathers, and other family
members as appropriate, concerning
postpartum conditions before new
mothers leave the health facility; and
(ii) ensuring that training programs
regarding such education are carried
out at the health facility.
(c) Integration With Other Programs.--To the extent
practicable and appropriate, the Secretary may integrate the
grant program under this section with other grant programs
carried out by the Secretary, including the program under
section 330.
(d) Certain Requirements.--A grant may be made under this
section 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 subsection (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 funded under subsection
(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.
(6) For each grant period, the applicant will submit
to the Secretary a report that describes how grant
funds were used during such period.
(e) Technical Assistance.--The Secretary may provide
technical assistance to entities seeking a grant under this
section in order to assist such entities in complying with the
requirements of this section.
(f) Definitions.--In this section:
(1) The term ``eligible entity'' means a public or
nonprofit private entity, which may include a State or
local government; a public or nonprofit private
recipient of a grant under section 330H (relating to
the Healthy Start Initiative), public-private
partnership, hospital, community-based organization,
hospice, ambulatory care facility, community health
center, migrant health center, public housing primary
care center, or homeless health center; or any other
appropriate public or nonprofit private entity.
(2) The term ``postpartum condition'' means
postpartum depression or postpartum psychosis.
* * * * * * *