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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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