Bill Text: NY S07355 | 2011-2012 | General Assembly | Introduced
Bill Title: Defines perinatal depression, requires the provision of perinatal depression education, and the provision of a screening and data reporting plan for the state.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2012-05-02 - REFERRED TO HEALTH [S07355 Detail]
Download: New_York-2011-S07355-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
7355
I N S E N A T E
May 2, 2012
___________
Introduced by Sen. KRUEGER -- read twice and ordered printed, and when
printed to be committed to the Committee on Health
AN ACT to amend the public health law and the insurance law, in relation
to defining perinatal depression, requiring the provision of perinatal
depression education, and requiring the provision of a screening and
data reporting plan for the state
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. The public health law is amended by adding a new section
2 2502-a to read as follows:
3 S 2502-A. PERINATAL DEPRESSION. 1. DEFINITIONS. AS USED IN THIS
4 SECTION:
5 (A) PERINATAL DEPRESSION MEANS A WIDE RANGE OF EMOTIONAL AND PSYCHO-
6 LOGICAL REACTIONS A MOTHER MAY EXPERIENCE AFTER CHILDBIRTH. THESE
7 REACTIONS MAY INCLUDE, BUT ARE NOT LIMITED TO, FEELINGS OF DESPAIR,
8 PROLONGED SADNESS, EXTREME GUILT, THOUGHTS OF SUICIDE, LACK OF ENERGY,
9 DIFFICULTY CONCENTRATING, FATIGUE, EXTREME CHANGES IN APPETITE, AND
10 THOUGHTS OF SUICIDE AND/OR OF HARMING THE BABY. PERINATAL DEPRESSION IS
11 COMMONLY CHARACTERIZED AS (1) "BABY BLUES"-THE MILDEST FORM; (2) POST-
12 PARTUM DEPRESSION; OR (3) POSTPARTUM PSYCHOSIS-THE SEVEREST FORM. THE
13 CHARACTERIZATION CORRESPONDS TO THE VARYING DEGREE TO WHICH THE MOTHER
14 EXPERIENCES SYMPTOMS.
15 (B) "MATERNAL HEALTH PROFESSIONAL" MEANS A PHYSICIAN, MIDWIFE, OR
16 OTHER AUTHORIZED PRACTITIONER ATTENDING A PREGNANT WOMAN.
17 2. DATA REPORTING FOR PERINATAL DEPRESSION. (A) THE DEPARTMENT SHALL
18 DEVELOP STANDARDS FOR EFFECTIVE SCREENING OF PERINATAL DEPRESSION USING
19 RECOGNIZED CLINICAL STANDARDS AND EVIDENCE-BASED PRACTICES. EFFECTIVE
20 STANDARDIZED, VALIDATED DIAGNOSTIC TOOLS USED FOR PERINATAL DEPRESSION
21 SCREENING MAY INCLUDE THE EDINBURGH POSTNATAL DEPRESSION SCALE (EPDS),
22 THE POSTPARTUM DEPRESSION SCREEN (PPDS), THE BECK DEPRESSION INVENTORY-
23 II (BDI-II), OR THE CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION SCALE
24 (CES-D).
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15669-01-2
S. 7355 2
1 (B) THE DEPARTMENT SHALL MAKE RECOMMENDATIONS TO HEALTH PLAN AND
2 HEALTH CARE PROVIDERS ON DATA REPORTING OF PERINATAL DEPRESSION SCREEN-
3 ING.
4 (C) THE DEPARTMENT SHALL ISSUE REGULATIONS THAT REQUIRE PROVIDERS AND
5 CARRIERS TO REPORT DATA ON THE SCREENING FOR PERINATAL DEPRESSION, THE
6 DIAGNOSED CASES OF PERINATAL DEPRESSION, AND RECOMMENDED OR PRESCRIBED
7 TREATMENT OPTIONS OR REFERRALS MADE, TO THE DEPARTMENT'S BUREAU OF
8 MATERNAL AND CHILD HEALTH.
9 (D) FOLLOWING THE RECEIPT OF THE SCREENING DATA, THE BUREAU OF MATER-
10 NAL AND CHILD HEALTH SHALL ISSUE AN ANNUAL SUMMARY OF ACTIVITIES RELATED
11 TO SCREENING FOR PERINATAL DEPRESSION, INCLUDING BEST PRACTICES; THE
12 SCREENING TOOLS USED OR IN CASES WHERE A VALIDATED TOOL WAS NOT USED,
13 REPORT IF ANY QUESTIONNAIRE OR DISCUSSION TO INDICATE POSSIBLE
14 DEPRESSION HAD BEEN OFFERED; THE NUMBERS OF DIAGNOSED AND TREATED CASES
15 OF PERINATAL DEPRESSION REPORTED BY PROVIDERS AND CARRIERS; AND RESULTS
16 OF ANY PRESCRIBED TREATMENT, INCLUDING THE OUTCOMES OF ANY REFERRALS FOR
17 FURTHER TREATMENT. THE BUREAU OF MATERNAL AND CHILD HEALTH SHALL FILE
18 THE SUMMARY ANNUALLY WITH THE COMMISSIONER AND WITH THE CLERKS OF THE
19 SENATE AND THE ASSEMBLY NO LATER THAN JUNE THIRTIETH; PROVIDED, HOWEVER,
20 THAT THE FIRST REPORT IS DUE NO LATER THAN JUNE THIRTIETH, TWO THOUSAND
21 THIRTEEN.
22 3. PERINATAL DEPRESSION PUBLIC EDUCATION. (A) THE COMMISSIONER SHALL
23 MAKE PERINATAL DEPRESSION INFORMATION LEAFLETS AVAILABLE ON THE HEALTH
24 DEPARTMENT'S WEBSITE, ACCESSIBLE TO EVERY MATERNAL HEALTH PROFESSIONAL
25 AND MATERNAL HEALTH CARE FACILITY, AS DESCRIBED IN SECTION TWENTY-EIGHT
26 HUNDRED THREE-J OF THIS CHAPTER. THE COMMISSIONER SHALL PERFORM AN
27 INITIAL REVIEW OF SUCH PERINATAL DEPRESSION INFORMATIONAL MATERIALS, IN
28 COLLABORATION WITH THE STATE BOARD OF MEDICINE AND STATE BOARD OF MENTAL
29 HEALTH PRACTITIONERS, TO EVALUATE THE CONTENTS FOR ADDRESSING ALL FORMS
30 OF PERINATAL DEPRESSION, AND IDENTIFYING RESOURCES FOR OBTAINING HELP
31 FOR THE INDIVIDUALS AND FAMILIES. ALL PERINATAL DEPRESSION INFORMATION
32 OUTLINED IN THIS SECTION SHALL BE PROVIDED IN THE TOP SIX LANGUAGES
33 OTHER THAN ENGLISH SPOKEN IN THE STATE ACCORDING TO THE LATEST AVAILABLE
34 DATA FROM THE U.S. BUREAU OF CENSUS, AND SHALL ADOPT ANY RULES AND
35 REGULATIONS NECESSARY TO ENSURE THAT SUCH PATIENTS, AND THEIR HEALTH
36 INFORMATION, IS TREATED IN ACCORDANCE WITH THE PROVISIONS OF SUCH STATE-
37 MENT, INCLUDING THOSE RULES ASSOCIATED WITH THE HEALTH INFORMATION
38 PORTABILITY AND ACCOUNTABILITY ACT. ALL MATERNAL HEALTH FACILITIES SHALL
39 BE REQUIRED TO PROVIDE THE PERINATAL DEPRESSION INFORMATIONAL LEAFLETS
40 TO THEIR PROFESSIONAL STAFF AND PATIENTS.
41 (B) THE COMMISSIONER SHALL BE AUTHORIZED TO GRANT AWARDS FOR THE
42 SUPPORT OF ADDITIONAL APPROVED PERINATAL DEPRESSION EDUCATION GRANT
43 PROGRAMS IN ACCORDANCE WITH SECTION TWENTY-FIVE HUNDRED TWENTY-TWO OF
44 THIS ARTICLE.
45 4. PERINATAL DEPRESSION TRAINING FOR MATERNAL HEALTH PROFESSIONALS.
46 (A) THE COMMISSIONER SHALL DEVELOP TUTORIAL TRAINING MATERIALS, IN
47 COLLABORATION WITH THE STATE BOARD OF MEDICINE, THE STATE BOARD OF
48 MENTAL HEALTH PRACTITIONERS, AND THE STATE BOARD OF NURSING. THE DEPART-
49 MENT SHALL PROVIDE TRAINING ON PERINATAL DEPRESSION SCREENING ON ITS
50 WEBSITE. THE TRAINING SHALL BE AVAILABLE TO EVERY MATERNAL HEALTH
51 PROFESSIONAL AND MATERNAL HEALTH CARE FACILITY.
52 (B) A TRAINED MATERNAL HEALTH PROFESSIONAL SHALL BE ABLE TO DO THE
53 FOLLOWING:
54 (1) IDENTIFY AND ADMINISTER APPROPRIATE DEPRESSION DIAGNOSTIC TOOLS,
55 SUCH AS THE EDINBURGH POSTNATAL DEPRESSION SCALE, TO ASSESS PERINATAL
56 DEPRESSION, WHICH SHALL BE PROVIDED BY THE DEPARTMENT ONLINE;
S. 7355 3
1 (2) APPROPRIATELY MANAGE MATERNAL RESPONSES, INCLUDING PERINATAL AND
2 MATERNAL DEPRESSION; AND
3 (3) UNDERSTAND HOW TO INTEGRATE SCREENINGS INTO ALL VISITS IN A
4 ROUTINE MANNER.
5 (C) THE COMMISSIONER SHALL PERFORM AN INITIAL REVIEW OF THE TUTORIAL
6 MATERIALS DESCRIBED IN PARAGRAPH (A) OF THIS SUBDIVISION, IN CONJUNCTION
7 WITH THE STATE BOARD OF MEDICINE, THE STATE BOARD OF MENTAL HEALTH PRAC-
8 TITIONERS, AND THE STATE BOARD OF NURSING, TO EVALUATE THE CONTENTS FOR
9 TRAINING MATERNAL HEALTH PROFESSIONALS TO APPROPRIATELY SCREEN FOR PERI-
10 NATAL DEPRESSION. ALL TRAINING MATERIALS SHALL BE AVAILABLE FOR MATERNAL
11 HEALTH FACILITIES TO VIEW AND/OR DOWNLOAD FOR TUTORIAL SESSIONS. AFTER
12 SUCH TUTORIALS, MATERNAL HEALTH PROFESSIONALS SHALL COMPLETE A QUESTION-
13 NAIRE TESTING THEIR ABILITY TO SCREEN MOTHERS; UPON SUCCESSFUL
14 COMPLETION, THEY SHALL SIGN A SCREENING AUTHORIZATION LETTER PROVIDED BY
15 THEIR HEALTH FACILITY.
16 5. SCREENING FOR PERINATAL DEPRESSION. (A) ALL QUALIFIED HEALTH
17 PROFESSIONALS SHALL SCREEN PREGNANT MOTHERS FOR PERINATAL DEPRESSION;
18 USING EFFECTIVE STANDARDIZED, VALIDATED DIAGNOSTIC TOOLS USED FOR PERI-
19 NATAL DEPRESSION SCREENING SUCH AS THE EDINBURGH POSTNATAL DEPRESSION
20 SCALE (EPDS), THE POSTPARTUM DEPRESSION SCREEN (PPDS), THE BECK
21 DEPRESSION INVENTORY-II (BDI-II), OR THE CENTER FOR EPIDEMIOLOGICAL
22 STUDIES-DEPRESSION SCALE (CES-D); OR EVEN WHERE SUCH SCREENING TOOLS MAY
23 NOT BE USED, THEY SHALL OFFER A BASIC QUESTIONNAIRE OR BRIEF DISCUSSION
24 TO INDICATE POSSIBLE DEPRESSION. THIS SHALL CONSIST OF THREE SCREENINGS
25 IN AN OBSTETRICAL SETTING, INCLUDING: (1) ONE IN THE FIRST TRIMESTER,
26 INCLUDING RISK ASSESSMENT BASED ON HISTORY OF PRIOR DEPRESSION; (2) ONE
27 IN THE THIRD TRIMESTER; AND (3) ONE AT THE SIX-WEEK POSTPARTUM VISIT OR
28 WITHIN THE FIRST MONTH OF LIFE. FURTHER, AFTER BIRTH, AT LEAST THREE
29 ADDITIONAL REQUIRED SCREENINGS IN A PEDIATRIC SETTING SHALL OCCUR; THIS
30 INCLUDES A RISK ASSESSMENT BASED ON HISTORY OF PRIOR DEPRESSION, AND
31 THREE SCREENINGS AT ROUTINE WELL-CHILD VISITS DURING THE CHILD'S FIRST
32 YEAR. ALL HEALTH CARE PROFESSIONALS SHALL ADHERE TO MANDATED CONFIDEN-
33 TIALITY REQUIREMENTS WHEN ACCESSING, DISCUSSING, REPORTING OR TRANSMIT-
34 TING THE RESULTS OF DEPRESSION SCREENS WHEN AVAILABLE IN A CHILD'S AND
35 MOTHER'S MEDICAL RECORD.
36 (B) IF A MOTHER SWITCHES OBSTETRICIANS OR NURSE MIDWIVES DURING PREG-
37 NANCY THE NEW PROVIDER SHALL PERFORM A SCREENING AND RISK ASSESSMENT AT
38 THE FIRST APPOINTMENT, AS WELL AS THE REMAINING SCREENINGS, AS OUTLINED
39 IN THIS SECTION. IF A WOMAN SWITCHES HER CHILDREN'S PEDIATRICIAN DURING
40 THE FIRST YEAR OF THE CHILD'S LIFE, THE NEW PEDIATRICIAN SHALL PERFORM A
41 SCREENING AND RISK ASSESSMENT AT THE FIRST APPOINTMENT, AS WELL AS AT AS
42 MANY OF THE REMAINING SCREENINGS AS POSSIBLE, AS OUTLINED IN THIS
43 SECTION.
44 (C) THE COMMISSIONER, IN CONJUNCTION WITH THE STATE BOARD OF MEDICINE,
45 THE STATE BOARD OF MENTAL HEALTH PRACTITIONERS, AND THE STATE BOARD OF
46 NURSING, SHALL RECOMMEND AND PROVIDE THE APPROPRIATE STANDARDIZED, VALI-
47 DATED DIAGNOSTIC TOOLS USED FOR ALL PERINATAL DEPRESSION SCREENING SUCH
48 AS THE EDINBURGH POSTNATAL DEPRESSION SCALE (EPDS), THE POSTPARTUM
49 DEPRESSION SCREEN (PPDS), THE BECK DEPRESSION INVENTORY-II (BDI-II), OR
50 THE CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION SCALE (CES-D).
51 (D) PHYSICIANS AND OTHER LICENSED HEALTH CARE WORKERS PROVIDING PRENA-
52 TAL AND POSTNATAL CARE TO WOMEN SHALL INCLUDE FATHERS AND OTHER FAMILY
53 MEMBERS, AS APPROPRIATE, IN BOTH THE EDUCATION AND TREATMENT PROCESSES
54 TO HELP THEM BETTER UNDERSTAND THE NATURE AND CAUSES OF PERINATAL
55 DEPRESSION.
S. 7355 4
1 (E) THE COMMISSIONER SHALL ENHANCE EXISTING REFERRAL LISTS FOR PROVID-
2 ERS; A LIST OF SERVICE PROVIDERS FOR INDIVIDUAL COUNSELING; AND A LIST
3 OF SUPPORT GROUPS AROUND THE STATE, INCLUDING ADEQUATE ACCESSIBLE
4 SERVICES OPERATED BY LOCAL NOT-FOR-PROFITS. SUCH ADDITIONAL REFERRALS
5 SHALL BE DISCUSSED BETWEEN THE PROVIDERS AND THE MOTHERS, INCLUDING
6 FATHERS AND OTHER FAMILY MEMBERS, WHEN APPROPRIATE.
7 S 2. Subdivision (g) of section 207 of the public health law, as
8 amended by section 16 of part A of chapter 109 of the laws of 2010 and
9 as relettered by chapter 331 of the laws of 2010, is amended to read as
10 follows:
11 (g) Improving birth outcomes, including the importance of preconcep-
12 tional care, early prenatal care, INCLUDING PERINATAL DEPRESSION,
13 considerations of health risks during pregnancy, considerations of bene-
14 fits and risks of labor and delivery options including, but not limited
15 to, vaginal and cesarean section delivery, elective or repeat cesarean
16 sections, and appropriate use of drugs during delivery.
17 S 3. Subparagraph (B) of paragraph 1 of subsection (c) of section 4303
18 of the insurance law, as amended by chapter 661 of the laws of 1997, is
19 amended to read as follows:
20 (B) Maternity care coverage also shall include, at minimum, parent
21 education, assistance and training in breast or bottle feeding, REPORT-
22 ING SIGNS OF PERINATAL DEPRESSION, and the performance of any necessary
23 maternal and newborn clinical assessments.
24 S 4. Subsection (a) of section 3217-c of the insurance law, as amended
25 by chapter 219 of the laws of 2011, is amended to read as follows:
26 (a) No insurer subject to this article shall by contract, written
27 policy or procedure limit a female insured's direct access to primary
28 and preventive obstetric and gynecologic services, including annual
29 examinations, care resulting from such annual examinations, and treat-
30 ment of acute gynecologic conditions, from a qualified provider of such
31 services of her choice from within the plan or for any care related to a
32 pregnancy, INCLUDING PERINATAL DEPRESSION, provided that: (1) such qual-
33 ified provider discusses such services and treatment plan with the
34 insured's primary care practitioner in accordance with the requirements
35 of the insurer; and (2) such qualified provider agrees to adhere to the
36 insurer's policies and procedures, including any applicable procedures
37 regarding referrals and obtaining prior authorization for services other
38 than obstetric and gynecologic services rendered by such qualified
39 provider, and agrees to provide services pursuant to a treatment plan
40 (if any) approved by the insurer.
41 S 5. Item (ii) of subparagraph (A) of paragraph 10 of subsection (i)
42 of section 3216 of the insurance law, as added by chapter 56 of the laws
43 of 1996, is amended to read as follows:
44 (ii) Maternity care coverage shall also include, at minimum, parent
45 education, assistance and training in breast or bottle feeding, PERINA-
46 TAL DEPRESSION, and the performance of any necessary maternal and
47 newborn clinical assessments.
48 S 6. Paragraph 1 of subsection (e) and subsection (f) of section 4804
49 of the insurance law, as added by chapter 705 of the laws of 1996, are
50 amended to read as follows:
51 (1) If an insured's health care provider leaves the insurer's in-net-
52 work benefits portion of its network of providers for a managed care
53 product for reasons other than those for which the provider would not be
54 eligible to receive a hearing pursuant to paragraph one of subsection
55 (b) of section forty-eight hundred three of this [chapter] ARTICLE, the
56 insurer shall permit the insured to continue an ongoing course of treat-
S. 7355 5
1 ment with the insured's current health care provider during a transi-
2 tional period of (i) up to ninety days from the date of notice to the
3 insured of the provider's disaffiliation from the insurer's network; or
4 (ii) if the insured has entered the second trimester of pregnancy at the
5 time of the provider's disaffiliation, for a transitional period that
6 includes the provision of post-partum care directly related to the
7 delivery, INCLUDING FOR PERINATAL DEPRESSION.
8 (f) If a new insured whose health care provider is not a member of the
9 insurer's in-network benefits portion of the provider network enrolls in
10 the managed care product, the insurer shall permit the insured to
11 continue an ongoing course of treatment with the insured's current
12 health care provider during a transitional period of up to sixty days
13 from the effective date of enrollment, if: (1) the insured has a life-
14 threatening disease or condition or a degenerative and disabling disease
15 or condition or (2) the insured has entered the second trimester of
16 pregnancy at the time of enrollment, in which case the transitional
17 period shall include the provision of post-partum care directly related
18 to the delivery INCLUDING FOR PERINATAL DEPRESSION. If an insured elects
19 to continue to receive care from such health care provider pursuant to
20 this paragraph, such care shall be authorized by the insurer for the
21 transitional period only if the health care provider agrees: (A) to
22 accept reimbursement from the insurer at rates established by the insur-
23 er as payment in full, which rates shall be no more than the level of
24 reimbursement applicable to similar providers within the in-network
25 benefits portion of the insurer's network for such services; (B) to
26 adhere to the insurer's quality assurance requirements and agrees to
27 provide to the insurer necessary medical information related to such
28 care; and (C) to otherwise adhere to the insurer's policies and proce-
29 dures including, but not limited to procedures regarding referrals and
30 obtaining pre-authorization and a treatment plan approved by the insur-
31 er. In no event shall this subsection be construed to require an insur-
32 er to provide coverage for benefits not otherwise covered or to diminish
33 or impair pre-existing condition limitations contained within the
34 insured's contract.
35 S 7. The state and private insurers shall establish a reimbursement
36 structure for perinatal depression screenings or where applicable follow
37 provisions pursuant to section 2530 of the public health law.
38 S 8. This act shall take effect on the one hundred eightieth day next
39 succeeding the date on which it shall have become a law; provided,
40 however, that effective immediately, the addition, amendment and/or
41 repeal of any rule or regulation necessary for the implementation of
42 this act on its effective date is authorized and directed to be made and
43 completed by the commissioner of health on or before such effective
44 date.
