Amendment #7 to H4773
Establishing a Maternal Mental Health Equity Grant Program
Ms. Kerans of Danvers moves to amend the bill by adding the following section:
"SECTION XXXX. Chapter 6A of the General Laws is hereby amended by inserting after section 16CC the following section:
Section 16DD. (a) As used in this section, the following words shall, unless the context requires otherwise, have the following meanings:
“Culturally congruent care”, care that is in agreement with the preferred cultural values, beliefs, worldview, language and practices of the health care consumer.
“Eligible entity”, a: (1) community-based organization serving pregnant and postpartum individuals, including organizations serving individuals from medically underserved populations and other underserved populations; (2) non-profit or patient advocacy organization with expertise in maternal mental and behavioral health; (3) maternity care provider; (4) mental or behavioral health care provider who treats maternal mental health conditions or substance use disorders; (5) public health agencies, including the department of public health or a local public health department; or (6) federally recognized Indian tribe or tribal organization.
“Freestanding birth center”, a health facility: (1) that is not a hospital; (2) where childbirth is planned to occur away from the pregnant woman's residence; (3) that is licensed or otherwise approved by the commonwealth to provide prenatal labor and delivery or postpartum care; and (4) that complies with other requirements established by the commonwealth relating to the health and safety of individuals provided services by the facility.
“Maternity care provider”, a health care provider who: (1) is a physician, physician assistant, certified nurse-midwife, nurse practitioner or clinical nurse specialist; and (2) has a focus on maternal or perinatal health.
“Medically underserved populations”, federally designated populations that have too few primary care providers, high infant mortality, high poverty or high elderly population.
“Mental or behavioral health care provider”, a health care provider in the field of mental or behavioral health, including substance use disorders, acting in accordance with the laws of the commonwealth.
“Secretary”, the secretary of health and human services.
(b) The secretary of health and human services shall establish a program to award grants to eligible entities to address maternal mental health conditions and substance use disorders with respect to pregnant and postpartum individuals, with a focus medically underserved populations.
(c) To receive a grant under this section an eligible entity shall submit to the secretary an application at such time, in such manner and containing such information as the secretary may require, including how the entity will use funds for activities described in subsection (e) that are culturally congruent.
(d) In awarding grants under this section, the secretary shall give priority to an eligible entity that:
(1) is partnering, or will partner, with a community-based organization to address maternal mental health conditions or substance use disorders described in subsection (a); and
(2) is operating in an area with high rates of adverse maternal health outcomes or significant racial or ethnic disparities in maternal health outcomes.
(e) An eligible entity that receives a grant under this section shall use funds for the following:
(1) establishing or expanding maternity care programs to improve the integration of maternal mental health and behavioral health care services into primary care settings where pregnant individuals regularly receive health care services;
(2) establishing or expanding group prenatal care programs or postpartum care programs;
(3) expanding existing programs that improve maternal mental health and behavioral health during the prenatal and postpartum periods, with a focus on individuals from medically underserved populations;
(4) providing services and support for pregnant and postpartum individuals with maternal mental health conditions and substance use disorders, including referrals to addiction treatment centers that offer evidence-based treatment options;
(5) addressing stigma associated with maternal mental health conditions and substance use disorders, with a focus on medically underserved populations;
(6) raising awareness of warning signs of maternal mental health conditions and substance use disorders, with a focus on pregnant and postpartum individuals from medically underserved populations;
(7) establishing or expanding programs to prevent suicide or self-harm among pregnant and postpartum individuals, including, but not limited to, the moms do care program administered by the bureau of substance addiction services in the department and the Massachusetts child psychiatry access program;
(8) offering evidence-aligned programs at freestanding birth centers that provide maternal mental and behavioral health care education, treatments, and services, and other services for individuals throughout the prenatal and postpartum period;
(9) establishing or expanding programs to provide education and training to maternity care providers with respect to identifying potential warning signs for maternal mental health conditions or substance use disorders in pregnant and postpartum individuals, with a focus on individuals from medically underserved populations. In the case where such providers identify such warning signs, offering referrals to mental or behavioral health care professionals;
(10) developing a website, or other method of publication, that includes information on health care providers who treat maternal mental health conditions and substance use disorders;
(11) establishing or expanding programs in communities to improve coordination between maternity care providers and maternal mental or behavioral health care providers who treat maternal mental health conditions and substance use disorders, including through the use of toll-free hotlines; and
(12) carrying out other programs aligned with evidence-based practices for addressing maternal mental health conditions and substance use disorders for pregnant and postpartum individuals, with a focus on medically underserved populations.
(f) An eligible entity that receives a grant under this section shall submit annually to the secretary, and make publicly available, a report on the activities conducted using funds received through a grant under this section. Such reports shall include quantitative and qualitative evaluations of such activities, including the experience of individuals who received health care through such grant.
(g) Not later than the end of each fiscal year that grants are awarded, the secretary shall submit to the governor and the clerks of the house of representatives and the senate a report that includes:
(1) a summary of the reports received under subsection (f);
(2) an evaluation of the effectiveness of grants awarded under this section;
(3) recommendations with respect to expanding coverage of evidence-based screenings and treatments for maternal mental health conditions and substance use disorders; and
(4) recommendations with respect to ensuring activities described under subsection (e) continue after the end of a grant period.