[DOCID: f:hr375.110]
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110th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 110-375
======================================================================
MELANIE BLOCKER-STOKES POSTPARTUM DEPRESSION RESEARCH AND CARE ACT
_______
October 15, 2007.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Dingell, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 20]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 20) to provide for research on, and services for
individuals with, postpartum depression and psychosis, having
considered the same, report favorably thereon with an amendment
and recommend that the bill as amended do pass.
CONTENTS
Page
Amendment........................................................ 2
Purpose and Summary.............................................. 4
Background and Need for Legislation.............................. 4
Hearings......................................................... 6
Committee Consideration.......................................... 6
Committee Votes.................................................. 6
Committee Oversight Findings..................................... 6
Statement of General Performance Goals and Objectives............ 6
New Budget Authority, Entitlement Authority, and Tax Expenditures 7
Earmarks and Tax and Tariff Benefits............................. 7
Committee Cost Estimate.......................................... 7
Congressional Budget Office Estimate............................. 7
Federal Mandates Statement....................................... 9
Advisory Committee Statement..................................... 9
Constitutional Authority Statement............................... 9
Applicability to Legislative Branch.............................. 10
Section-by-Section Analysis of the Legislation................... 10
Changes in Existing Law Made by the Bill, as Reported............ 11
Amendment
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
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 12 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 to 20 percent of new mothers; and postpartum psychosis
striking 1 in 1,000 new mothers.
(7) 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.
(8) 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.
(9) Untreated, postpartum depression can lead to further
depression, substance abuse, loss of employment, divorce and
further social alienation, self-destructive behavior, or even
suicide.
(10) Untreated, postpartum depression impacts society through
its effect 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.
(a) In General.--The Secretary of Health and Human Services, acting
through the Director of the National Institutes of Health and the
Director of the National Institute of Mental Health (in this title
referred to as the ``Institute''), is encouraged to continue aggressive
work on postpartum depression and postpartum psychosis.
(b) Coordination With Other Institutes.--The Director of the
Institute should continue to coordinate 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 is encouraged to continue 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 screening and 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.
SEC. 102. NATIONAL PUBLIC AWARENESS CAMPAIGN.
(a) In General.--The Director of the National Institutes of Health
and the Administrator of the Health Resources and Services
Administration are encouraged to carry out a coordinated national
campaign to increase the awareness and knowledge of postpartum
depression and postpartum psychosis.
(b) Public Service Announcements.--Activities under the national
campaign under subsection (a) may include public service announcements
through television, radio, and other means.
SEC. 103. BIENNIAL REPORTING.
Section 403(a)(5) of the Public Health Service Act (42 U.S.C.
283(a)(5)) is amended--
(1) by redesignating subparagraph (L) as subparagraph (M);
and
(2) by inserting after subparagraph (K) the following:
``(L) Depression.''.
SEC. 104. LONGITUDINAL STUDY OF RELATIVE MENTAL HEALTH CONSEQUENCES FOR
WOMEN OF RESOLVING A PREGNANCY.
(a) Sense of Congress.--It is the sense of Congress that the Director
of the Institute may conduct a nationally representative longitudinal
study (during the period of fiscal years 2008 through 2018) of the
relative mental health consequences for women of resolving a pregnancy
(intended and unintended) in various ways, including carrying the
pregnancy to term and parenting the child, carrying the pregnancy to
term and placing the child for adoption, miscarriage, and having an
abortion. This study may assess the incidence, timing, magnitude, and
duration of the immediate and long-term mental health consequences
(positive or negative) of these pregnancy outcomes.
(b) Report.--Beginning not later than 3 years after the date of the
enactment of this Act, and periodically thereafter for the duration of
the study under subsection (a), the Director of the Institute should
prepare and submit to the Congress reports on the findings of the
study.
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'') should 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 any 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 should 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.
TITLE III--GENERAL PROVISIONS
SEC. 301. AUTHORIZATION OF APPROPRIATIONS.
To carry out this Act and the amendments made by this Act, there are
authorized to be appropriated--
(1) $3,000,000 for fiscal year 2008; and
(2) such sums as may be necessary for fiscal years 2009 and
2010.
Purpose and Summary
The purpose of H.R. 20, the Melanie Blocker-Stokes
Postpartum Depression Research and Care Act, is to provide
research on and services for individuals with postpartum
depression and psychosis.
Background and Need for Legislation
Depression is an exceedingly common disorder, affecting 15
to 25 percent of the population and representing a yearly
economic burden of $44 billion. Overall, depression is
frequently undetected, with fewer than 25 percent of patients
suffering from mental illness actually under the care of a
mental health specialist. Depression is twice as common in
women as it is in men, with its peak incidence during the
primary reproductive years--ages 25 to 45. Because women are
more likely to experience depression during these years, they
are especially vulnerable to developing depression during
pregnancy and after childbirth.
Following childbirth, some women may experience postpartum
disorders that can adversely affect a woman's mental health.
The spectrum of postpartum mood disorders is generally divided
into three distinct categories. At the mildest end of the
spectrum is the ``maternity blues'' or ``baby blues.'' Because
this condition arises after 40 to 85 percent of deliveries,
practitioners and patients often view it as a normal
phenomenon. Nonetheless, the patient and their families are
distressed by the patient's depressed mood, irritability,
anxiety, confusion, crying spells, mood lability (refers to
mood swings and the changeability of a person's overall mood
state), and disturbances in sleep and appetite. These symptoms
peak between postpartum days 3 and 5, and typically resolve
spontaneously within 24 to 72 hours.
At the other end of the spectrum is the truly devastating
postpartum psychosis. A comparatively rare disease, it
complicates only 0.1 to 0.2 percent of deliveries. Symptoms
generally present within the first 4 weeks of postpartum, when
the risk of hospitalization is 22 times greater, but can
manifest up to 90 days after delivery. A second smaller peak in
incidence is evident at 18 to 24 months. Patients suffering
from postpartum psychosis are severely impaired, suffering from
hallucinations and delusions that frequently focus on the
infant dying or being divine or demonic. These hallucinations
often command that the patient hurt herself or others, placing
these mothers at the highest risk for committing infanticide
and/or suicide.
Between these two extremes is postpartum depression, which
is recognized as a unique and serious complication of
childbirth. Its insidious onset and chronic course complicates
10 to 15 percent of all deliveries and a staggering 26 to 32
percent of all adolescent deliveries. The majority of patients
suffer from this illness for more than 6 months and, if
untreated, 25 percent of patients are still depressed a year
later. Women with postpartum depression may feel restless,
anxious, sad, or depressed. They may have feelings of guilt,
decreased energy and motivation, and a sense of worthlessness.
They may also have sleep difficulties and undergo unexplained
weight loss or gain.
Research suggests that the following factors may contribute
to the onset of postpartum depression:
Hormonal Changes: A woman experiences the greatest
hormonal fluctuation levels after giving birth. Intense
hormone fluctuations, such as decreased serotonin
levels, occur after delivery and may play a role in the
development of postpartum depression.
Situational Risks: Childbirth itself is a major life
change and transition, and big changes can cause a
great deal of stress that result in depression. If a
major event coincides with childbirth, a mother may be
more susceptible to postpartum depression.
Life Stresses: Ongoing stressful circumstances can
compound the pressure of having a new baby and may
trigger postpartum depression.
Hearings
The Committee on Energy and Commerce held a legislative
hearing on H.R. 20 on May 1, 2007. The Subcommittee heard from
two panels of witnesses and experts. The first panel consisted
of testimony by Catherine Roca, M.D., Chief, Women's Programs,
National Institute of Mental Health, National Institutes of
Health. The second panel had five witnesses: Nada Scotland,
M.D., M.P.H., Professor of Psychiatry and Obstetrics/
Gynecology, Rush Medical College, Chicago (testifying on behalf
of the American Psychiatric Association); Ms. Mary Jo Codey,
Former First Lady of the State of New Jersey; Ms. Carol
Blocker, mother of Melanie Blocker-Stokes; Priscilla K.
Coleman, PhD., Associate Professor of Human Development and
Family Studies, Bowling State University; and Ms. Michaelene
Fredenburg, President, Life Perspectives.
Committee Consideration
On Thursday, July 19, 2007, the Subcommittee on Health met
in open markup session and ordered H.R. 20 favorably forwarded
to the full Committee, amended, by a voice vote. On Thursday,
September 27, 2007, the full Committee met in open markup
session and ordered H.R. 20 favorably reported to the House, as
amended by the Subcommittee, by a voice vote. No amendments
were offered during full Committee consideration.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no recorded votes taken during consideration or
reporting H.R. 20. A motion by Mr. Dingell to order H.R. 20
favorably reported to the House, as amended, was agreed to by a
voice vote.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Subcommittee on Health has held
legislative hearings on this legislation and made oversight
findings that are reflected in this report.
Statement of General Performance Goals and Objectives
H.R. 20 encourages the Secretary of Health and Human
Services (HHS), acting through the Director of the National
Institutes of Health (NIH) and the Director of the National
Institute of Mental Health (NIMH), to continue aggressive
research and related activities on postpartum depression and
postpartum psychosis. H.R. 20 encourages the Director of NIMH
to conduct or support research to expand the understanding of
the causes of, and to find a cure for, such conditions. H.R. 20
states that the Secretary should make grants to establish,
operate, and coordinate effective and cost-efficient systems
for the delivery of essential services to individuals with such
conditions and their families. This legislation further allows
the Secretary to provide technical assistance to grant
recipients.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
20 would result in no new or increased budget authority,
entitlement authority, or tax expenditures.
Earmarks and Tax and Tariff Benefits
In compliance with clause 9 of rule XXI of the Rules of the
House of Representatives, H.R. 20 does not contain any
congressional earmarks, limited tax benefits, or limited tariff
benefits as defined in clause 9(d), 9(e), or 9(f) of rule XXI.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
provided by the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, October 12, 2007.
Hon. John D. Dingell,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 20, the Melanie
Blocker-Stokes Postpartum Depression Research and Care Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Sarah Evans.
Sincerely,
Robert A. Sunshine
(For Peter R. Orszag, Director).
Enclosure.
H.R. 20--Melanie Blocker-Stokes Postpartum Depression Research and Care
Act
Summary: H.R. 20 would encourage the Secretary of Health
and Human Services (HHS) to continue ongoing activities at the
National Institutes of Health (NIH) and the Health Resources
and Services Administration (HRSA) related to research and
dissemination of information concerning postpartum depression
or postpartum psychosis. The bill also would direct the
Secretary to provide grants to public or nonprofit entities to
establish and operate programs that provide health care and
support services to individuals with postpartum depression or
postpartum psychosis.
The bill would authorize the appropriation for those
purposes of $3 million for fiscal year 2008 and such sums as
necessary for fiscal years 2009 and 2010. CBO estimates that
implementing the bill would cost less than $500,000 in 2008 and
$18 million over the 2008-2012 period, assuming the
appropriation of the authorized amounts. Enacting H.R. 20 would
not affect direct spending or revenues.
The bill contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA);
any costs to state and local governments would be incurred
voluntarily.
Estimated cost to the Federal government: The estimated
budgetary impact of H.R. 20 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
------------------------------------------------------------------------
By fiscal year, in millions of
dollars--
---------------------------------------
2008 2009 2010 2011 2012
------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATION
Estimated Authorization Level... 3 3 13 0 0
Estimated Outlays............... * 2 6 8 2
------------------------------------------------------------------------
Note: * = less than $500,000.
Basis of estimate: For this estimate, CBO assumes that H.R.
20 will be enacted near the start of the fiscal year 2008, that
the authorized amounts will be appropriated for each year, and
that outlays will follow historical spending patterns for
similar programs.
Research on postpartum depression and psychosis
H.R. 20 would encourage the Secretary of HHS, acting
through the Director of the NIH, to continue research efforts
related to postpartum depression and postpartum psychosis. Such
research includes basic research, epidemiological research, the
development of improved diagnostic techniques, clinical
research, and information and education programs. According to
officials at the NIH, the institutes currently support all of
those activities.
The bill also would encourage the Director of the NIH and
the Administrator of HRSA carry out a national campaign,
potentially including public service announcements, to raise
awareness of postpartum depression. According to officials at
the NIH, the institutes already communicate and disseminate
their research findings as required by law. Both the NIH and
HRSA sponsor Web sites devoted to postpartum depression.
According to officials at HHS, HRSA frequently uses public
service announcements to communicate messages to the public.
CBO estimates that there would be no cost to HRSA to
implement those provisions, because they would not involve any
change in the agency's activities. Likewise, CBO estimates that
the NIH would incur no costs in 2008 or 2009, because those
provisions would not require any new activities at the NIH.
However, under current law (title IV of the Public Health
Service Act) authorization for the activities of the NIH
expires at the end of fiscal year 2009. Based on the proportion
of grants for depression-related research that is specifically
for postpartum-related depression, CBO estimates that NIH would
require about $10 million for 2010 to continue its research and
information-dissemination programs on postpartum depression and
psychosis. Assuming the appropriation of the necessary amount,
CBO estimates that implementing those programs would cost $9
million over the 2010-2012 period.
Grants for services related to postpartum depression and psychosis
H.R. 20 would authorize the Secretary of HHS to make grants
to public or nonprofit entities for the establishment,
operation, and coordination of systems for delivery of services
to individuals with postpartum depression or postpartum
psychosis. Not more than 5 percent of these grants could be
used for administration, accounting, reporting, or program
oversight. These grants would not be permitted to supplant
funds from other sources, including federal and state health
programs.
For carrying the activities in the entire bill, H.R. 20
would authorize the appropriation of $3 million in fiscal year
2008 and such sums as necessary in fiscal years 2009 and 2010.
CBO estimates that the $3 million authorized for appropriation
in 2008 would fund a postpartum services grant program
consistent with the requirements of the bill (none of the $3
million would be required for the other activities under the
bill as described above). CBO estimates that an additional $3
million a year would be necessary to fund the grant program in
2009 and 2010. Implementing the grant program would cost less
than $500,000 in 2008 and $9 million over the 2008-2012 period,
CBO estimates.
Intergovernmental and Private-Sector Impact: HR. 20
contains no intergovernmental or private-sector mandates as
defined in UMRA. Grants authorized in the bill for the study
and treatment of paralysis and other physical disabilities
would benefit state and local governments that provide services
for diagnosing and managing postpartum depression. Any costs to
those governments to comply with grant conditions would be
incurred voluntarily.
Estimate prepared by: Federal Costs: Sarah Evans; Impact on
State, Local, and Tribal Governments: Lisa Ramirez-Branum;
Impact on the Private Sector: Keisuke Nakagawa.
Estimate approved by: Keith J. Fontenot, Deputy Assistant
Director for Health and Human Resources, Budget Analysis
Division.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
Constitutional authority for this legislation is provided in
the provisions of Article I, section 8, clause 1 that relate to
expending funds to provide for the general welfare of the
United States.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 establishes the short title of the Act as the
``Melanie Blocker-Stokes Postpartum Depression Research and
Care Act.''
Section 2. Findings
Section 2 sets out the findings of the Act.
Title I. Research on postpartum depression and psychosis
Title I addresses the activities and research related to
postpartum depression and psychosis. Section 101 encourages the
Secretary of Health and Human Services, the Director of the
National Institute of Mental Health, and the Director of the
National Institutes of Health to coordinate activities and
continue aggressive work with respect to postpartum depression
and postpartum psychosis. In addition, the Director of NIMH is
encouraged to continue supporting research on understanding the
causes of postpartum depressions and finding a cure through
activities such as basic research concerning the etiology and
causes of the conditions; 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; development of improved screening and diagnostic
techniques; clinical research for the development and
evaluation of new treatments; and information and education
programs for healthcare professionals and the public.
Section 102 encourages the Director of NIH and the
Administrator of the Health Resources and Services
Administration to carry out a coordinated national campaign to
increase the awareness and knowledge of postpartum depression
and postpartum psychosis.
Section 103 amends a section of the Public Health Service
Act that requires the Director of NIH to submit a biennial
report to Congress providing summaries of the research
activities throughout the agency with respect to certain
diseases, conditions, and issues. Section 103 adds
``depression'' as one of the conditions for which NIH must
provide information about in the biennial report.
Section 104 includes a sense of Congress that the Director
of NIMH may conduct a nationally representative longitudinal
study of the relative mental health consequences for women of
resolving a pregnancy in various ways including carrying the
pregnancy to term and parenting the child, carrying the
pregnancy to term and placing the child for adoption,
miscarriage, and having an abortion.
Title II. Delivery of services regarding postpartum depression and
psychosis
Title II addresses the establishment of grant programs
related to postpartum depression and psychosis. Section 201
directs the Secretary of HHS to 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. Recipients of these grants must be either
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 or homeless
health center; or other appropriate public or nonprofit private
entity. To the extent practicable, the Secretary shall ensure
that these grants provide services for the diagnosis and
management of postpartum conditions.
Section 202 requires that grant recipients meet certain
requirements and make 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; (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; and (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.
Section 203 states that 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.
Title III. General provisions
Title III authorizes $3,000,000 to be appropriated for
fiscal year 2008, and such sums as may be necessary for fiscal
years 2009 and 2010.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE IV--NATIONAL RESEARCH INSTITUTES
PART A--National Institutes of Health
* * * * * * *
SEC. 403. BIENNIAL REPORTS OF DIRECTOR OF NIH.
(a) In General.--The Director of NIH shall submit to the
Congress on a biennial basis a report in accordance with this
section. The first report shall be submitted not later than 1
year after the date of the enactment of the National Institutes
of Health Reform Act of 2006. Each such report shall include
the following information:
(1) * * *
* * * * * * *
(5) A summary of the research activities throughout
the agencies, which summary shall be organized by the
following categories, where applicable:
(A) * * *
* * * * * * *
(L) Depression.
[(L)] (M) Such additional categories as the
Director determines to be appropriate.
* * * * * * *
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