BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 159
                                                                  Page  1

          Date of Hearing:   April 22, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                     AB 159 (Nava) - As Amended:  March 25, 2009 

          Policy Committee:                              Health Vote:17-0

          Urgency:     No                   State Mandated Local Program:   
          No     Reimbursable:              

           SUMMARY  

          This bill authorizes the California Department of Public Health  
          (DPH) to establish a statewide perinatal mood and anxiety  
          disorders (PMAD) task force. Specifically, this bill: 

          1)Requires, if DPH establishes the task force, membership to  
            include specific stakeholders, including patients and provider  
            groups. 

          2)Authorizes the PMAD task force to increase awareness, provide  
            assistance, disseminate educational materials, use television  
            and print advertisements, establish a website, and identify  
            barriers to perinatal depression screenings. 

          3)Requires DPH to make related PMAD recommendations to the  
            Legislature and governor. 

          4)Establishes a continuously appropriated special fund and  
            requires that only non-public funds deposited into the special  
            fund be used to support the PMAD task force and activities  
            established by this bill. 

           FISCAL EFFECT  

          1)One-time GF cost pressures of $300,000 and on-going GF cost  
            pressures of $200,000 to staff a stakeholder group, design  
            educational materials, provide technical assistance, manage  
            media contracts, establish a website, and make recommendations  
            related to PMAD screening. 

          2)Major GF cost pressures in the range of $2 million to $4  
            million for a statewide public information campaign, including  








                                                                  AB 159
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            television and print media. 

          Recent statewide campaigns of this kind have ranged from $5  
            million to $15 million for BabyCal and tobacco prevention  
            media campaigns. BabyCal communicated the importance of early  
            and ongoing prenatal care, practicing healthy behavior during  
            pregnancy, and the availability of state programs that can  
            help pay for prenatal services. Various statewide tobacco  
            education and prevention campaigns funded by Proposition 99  
            have been conducted in recent years. In the current year, a  
            $15 million tobacco prevention campaign is underway. 

          3)This bill requires the use of non-public funds. However, no  
            such funds have been identified at this time. Therefore, this  
            bill creates significant GF pressures. If nonpublic funds are  
            committed to this endeavor, current law authorizes gifts and  
            an expression of donor intent to the state of California for  
            specified purposes and subject to the approval by the Director  
            of the Department of Finance. 

           COMMENTS  

           1)Rationale  . This bill, sponsored by the California Junior  
            League, increases the visibility of perinatal depression and  
            increases the uniformity of information statewide. Perinatal  
            depression includes both major and minor depressive episodes  
            that occur during pregnancy or during the first 12 months  
            following delivery. According to the author, despite the  
            severity and frequency of perinatal depression, California  
            families are not adequately informed and women are not  
            screened for the condition. Estimates of perinatal depression  
            incidence range from 5% to 25% of pregnant women. This bill  
            authorizes DPH to embark on a deliberate and ambitious public  
            awareness campaign about these issues, subject to the  
            availability of non-public funds.  

           2)Depression  is the leading cause of disease-related disability  
            among women. Women of childbearing age are at significant risk  
            for major depression. Pregnancy and new motherhood sometimes  
            increase the risk of depressive episodes. Depression during  
            the perinatal period can have devastating consequences for  
            women and their children and families. Only a fraction of  
            those women with depressive symptoms ever receive treatment. A  
            lack of treatment and worsening symptoms often have a negative  
            impact on parenting, family life, and sometimes leads to  








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            suicide or infanticide. 

           3)Comprehensive Perinatal Services Program  (CPSP), administered  
            by DPH, provides Medi-Cal-eligible women with comprehensive  
            services, including prenatal care, health education, nutrition  
            services, and psychosocial support for up to 60 days after  
            delivery of their infants.  Local health departments provide  
            technical assistance and consultation to providers.  DPH   
            maintains an ongoing program of training for all CPSP  
            practitioners throughout the state.

           4)Related Legislation  . AB 420 (Salas), pending in this  
            committee, also addresses a PMAD education campaign and  
            workgroup. AB 420 also specifies that only non-public funds  
            may be used for implementation of the bill's requirements. 

          AB 367 (Koretz), AB 291 (Koretz), and AB 2317 (Koretz), each  
            addressed PMAD information and education programs in 2003,  
            2005, and 2006, respectively. AB 367 was held on the Suspense  
            File of this committee, AB 291 was not taken up in the  
            Assembly Health Committee, and AB 2317 was vetoed. The veto  
            message indicates drafting errors in AB 2317 would have made  
            the program unworkable. 


           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081