BILL ANALYSIS
ACR 105
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Date of Hearing: March 23, 2010
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
ACR 105 (Nava) - As Amended: March 9, 2010
SUBJECT : Perinatal Depression Awareness Month.
SUMMARY : Establishes May, each year, as Perinatal Depression
Awareness Month in California and requests that stakeholders
work together to increase awareness and improve women's access
to culturally competent mental health care services.
Specifically, this resolution :
1)Proclaims May, each year, as Perinatal Depression Awareness
Month in California.
2)Requests the Department of Health Care Services, the
Department of Public Health (DPH), the Department of Mental
Health, First 5 California, Postpartum Support International,
and other motivated stakeholders to work together to explore
ways to improve women's access to mental health care at the
state and local levels, to facilitate increased awareness and
education about perinatal depression and related mood
disorders, and to explore and encourage the implementation of
universal use of perinatal treatment and community-based
supportive services.
EXISTING LAW :
1)Authorizes and requires DPH to implement various disease
prevention and health promotion programs, including a program
for maternal and child health. Authorizes the maternal and
child health program to include the provision of educational,
preventative, diagnostic, and treatment services, including
medical care and facilitating services directed toward
improving the health of mothers and children.
2)Establishes the comprehensive community-based perinatal
program to provide comprehensive perinatal care for the
purpose of reducing maternal, perinatal, and infant mortality
and morbidity through contracts, grants, and agreements with
health care providers through the Medi-Cal Program.
FISCAL EFFECT : None
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COMMENTS :
1)PURPOSE OF THIS RESOLUTION . According to the author, despite
the high prevalence of perinatal depression, which is also
known as perinatal mood and anxiety disorder (PMAD), many
women are not adequately informed about, screened for, or
treated for PMAD, and the state has not created a uniform
standard of care or laws to address PMAD information,
treatment or resources. The author states there is a
significant need for women and their families to be educated
and made aware of the statistics and symptoms related to PMAD,
the treatment and support options available, and that the
stigma associated with PMAD prevents many at-risk women from
accepting services and treatment for their disorder. The
level of severity of a PMAD episode has potentially serious
repercussions on the psychological, social, and physical
health of mothers, children, and their families. Postpartum
depression can even sometimes develop into psychosis following
a traumatic event. The author highlights the story of
Kristina Fuelling, a Placer County mother who was sentenced to
over six years in custody after suffering postpartum
depression that developed into psychosis, resulting in her
drowning her infant in the family home on Jan. 20, 2008. Her
mental state was verified by two court doctors.
2)BACKGROUND . A 2003 study featured in an article in the
Journal of Women's Health indicates that one in five pregnant
women suffered significant symptoms of depression, and only
14% of them reported receiving any formal treatment for it.
According to the United States Centers for Disease Control and
Prevention (CDC), nearly 12% of mothers report being
moderately depressed and 6% report being severely depressed
after delivery. Maternal depressive symptoms have been shown
to affect a mother's responsiveness to her child in its first
few months. Children of depressed women are also at increased
risk for child abuse, depression, and other psychiatric
illnesses such as conduct disorder. The CDC also states
postpartum depression affects marital relationships.
The American College of Obstetricians and Gynecologists (ACOG)
advocates addressing psychosocial issues of women in their
childbearing years. In a Committee Opinion published in
August 2006, the ACOG Committee on Health Care for Underserved
Women states psychosocial screening should be performed at
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least once each trimester for all women seeking pregnancy
evaluation or prenatal care. The Committee Opinion states
women who receive psychosocial screening each trimester are
half as likely to have a low-birth-weight or preterm baby.
The Committee Opinion also states the prevalence of major
depression in pregnancy is 11%, and if not treated, is
associated with unfavorable health behaviors and subsequent
fetal growth restriction, preterm delivery, placental
abruption (a cause of bleeding and maternal and fetal
mortality), and newborn irritability.
3)SUPPORT . According to the sponsors of ACR 105, State Public
Affairs Committee of the Junior Leagues of California, it is
estimated that one in five new mothers experience some form of
PMAD and are needlessly suffering through this devastating
medical condition. The Los Angeles County Perinatal Mental
Health Task Force (Task Force) states that as a consequence of
limited awareness, as well as, the lack of requisite knowledge
and skills needed for detection and treatment of PMAD, women
who suffer from PMAD experience isolation, shame, and
self-blame. The Task Force maintains ACR 105 is a critically
important step in removing the profound stigma surrounding
PMAD.
4)PREVIOUS LEGISLATION .
a) AB 159 (Nava), of 2009, would have authorized DPH to
establish a statewide task force to develop a best
practices model for public awareness and a standard of care
for PMAD to be used by health care providers and
organizations. AB 159 died on the Assembly Appropriations
Committee Suspense File.
b) AB 420 (Salas), of 2009, would have required DPH to
conduct the PMAD Community Awareness Campaign to increase
awareness and provide education to pregnant women and new
mothers on PMAD and to convene a workgroup, which would
have been required to prepare recommendations relating to
the implementation of the awareness campaign. AB 420 would
have authorized DPH to use nonpublic sources of funding to
support the activities of the workgroup and fund the
campaign, and prohibited the use of public funds. AB 420
died on the Assembly Appropriations Committee Suspense
File.
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c) AB 2317 (Koretz) of 2006, would have required DPH [then
Department of Health Services (DHS)] to conduct the PMAD
Community Awareness Campaign. The Governor vetoed AB 2317,
stating, "As crafted, the bill is technically flawed. It
will not result in an effective community awareness
campaign because it establishes program parameters and a
time frame that are not workable, and lacks proper
funding."
d) AB 291 (Koretz) of 2005, would have required DPH (then
DHS) to prepare an information sheet on postpartum mood and
anxiety disorders and would have required health care
providers to provide a copy of the information sheet to
pregnant women, as specified. AB 291 was not heard in the
Assembly Health Committee at the request of the author.
e) AB 367 (Koretz) of 2003, would have established the PMAD
Information Program in DPH (then DHS) Maternal and Child
Health Branch and would have required the program to
include continuing medical education activities, the
posting of relevant information on the DPH Website, and
communication through radio, TV, and billboards. AB 367
was held in the Assembly Appropriations Committee.
f) ACR 51 (Koretz), Resolution Chapter 50, Statutes of
2003, Proclaims May 2003 as Postpartum Mood and Anxiety
Disorder Awareness Month.
REGISTERED SUPPORT / OPPOSITION :
Support
State Public Affairs Committee, Junior Leagues of California
(sponsor)
California Communities United Institute
California Nurse Midwives Association
California Public Defenders Association
Junior League of Long Beach
Junior League of Pasadena
Junior League of Sacramento
Junior League of San Francisco
La Best Babies Network
Los Angeles County Perinatal Mental Health Task Force
South Bay Center for Counseling
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Opposition
None on File.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097