BILL ANALYSIS �
ACR 148
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Date of Hearing: June 10, 2014
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
ACR 148 (Lowenthal) - As Introduced: May 7, 2014
SUBJECT : Task Force on the Status of Maternal Mental Health
Care.
SUMMARY : Requests that the California Maternal Mental Health
Collaborative establish a task force on the status of maternal
mental health care in order to further the objectives of
identifying and treating maternal mental health disorders.
Specifically, this resolution :
1)Makes legislative findings and declarations related to
maternal mental health, including:
a) Women in their childbearing years account for the
largest group of Americans with depression and maternal
depression and other mood disorders are treatable
disorders;
b) Children born to mothers with untreated depression are
more likely to have developmental problems and higher
utilization of medical and mental health care over their
lifetimes; and,
c) It is critical that women who are suffering from
depression or another maternal mental health disorder be
diagnosed and treated.
2)Establishes a task force to study, review, and identify
current barriers to screening and diagnosis, current treatment
options, and evidence based and emerging treatment options
that are scalable in public and private health settings.
Declares that the task force should be established as follows:
a) The task force should consist of 12 to 18 members and
include representation from organizations such as the State
Department of Health Care Services, the State Department of
Public Health (DPH), the Office of Perinatal Substance
Abuse, the State Department of Developmental Services, the
Children and Family Services Division of the State
Department of Social Services, First 5 California, the
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American Congress of Obstetricians and Gynecologists
(ACOG), and other stakeholders;
b) The task force members should be appointed by the
California Maternal Mental Health Collaborative in
consultation with the Assembly and Senate Committees on
Health, and should meet at least eight times a year; and,
c) The task force should make recommendations in a white
paper no later than December 31, 2015.
FISCAL EFFECT : None
COMMENTS :
1)PURPOSE OF THIS RESOLUTION . According to the author,
perinatal depression and other mood disorders are serious and
debilitating, but treatable disorders that affect childbearing
women and their families; children born to mothers with
untreated depression are more likely to have developmental
challenges and higher utilization of medical and mental health
care over their lifetimes. It is critical that women who are
suffering from depression or other maternal mental health
disorders be diagnosed and treated.
2)BACKGROUND . The Los Angeles County Perinatal Mental Health
Task Force indicates that of the approximately 150,000 live
births occurring in Los Angeles County each year, over 22,000
women experience clinical perinatal depression. Perinatal or
maternal depression encompasses a range of mood disorders that
can affect a woman during pregnancy and around the time of
birth. Left untreated, maternal depression leads to long-term
depression in the mother, a lack of emotional availability for
the baby, and detrimental outcomes in the development of the
fetus, newborn, and developing child.
ACOG advocates for 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
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
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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.
The California Maternal Mental Health Collaborative was
established in 2011 as a result of the passage of ACR 105
(Nava), Resolution Chapter 9, Statutes of 2010, which declared
May as Perinatal Depression Awareness month in California.
ACR 105 also urged private and public stakeholders to form a
volunteer task force to address opportunities for increasing
awareness of and screening for maternal mental health
disorders. The stated mission of the California Maternal
Mental Health Collaborative is to bring stakeholders together
to exchange ideas, identify barriers and opportunities and
form collaborative relationships to increase and improve
maternal mental health awareness, diagnosis and treatment in
California and beyond. In 2013 the organization launched with
its partner, Postpartum Support International, a web-based
training in maternal mental health to address the shortage of
trained providers, and its national campaign, called the 2020
Mom Project, which sets forth tactical steps that hospitals,
insurers and providers can take to improve awareness and
outcomes.
3)SUPPORT . According to the author, the sponsor of this
resolution, the California Maternal Mental Health
Collaborative, states that women in their childbearing years
account for the largest group of Americans with depression,
often referred to as postpartum depression, maternal
depression or perinatal depression. Postpartum depression,
related to pregnancy and motherhood, is the most common
complication of childbirth.
4)PREVIOUS LEGISLATION .
a) ACR 105 (Nava), Resolution Chapter 9, Statutes of 2010,
establishes May of 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.
b) AB 159 (Nava), of 2009, authorizes DPH to establishes a
statewide task force to develop a best practices model for
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public awareness and a standard of care for perinatal mood
and anxiety disorders to be used by health care providers
and organizations. AB 159 was held in the Assembly
Appropriations Committee.
c) 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
was held in the Assembly Appropriations Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
California Maternal Mental Health Collaborative (sponsor)
American Congress of Obstetricians and Gynecologists
Opposition
None on file.
Analysis Prepared by : Paula Villescaz / HEALTH / (916)
319-2097