,,ii #aagth ,,congress #b;d ,session ,s4 #chbd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ad1 #bjbb,mrs4 ,gillibrand 7for herself1 ,mrs4 ,capito1 ,ms4 ,baldwin1 and ,ms4 ,murkowski7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to reauthorize a grant program for screening1 assessment1 and treatment services for maternal mental health and substance use disorders1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,into the ,light for ,maternal ,mental ,health and ,substance ,use ,disorders ,act of #bjbb or the ,into the ,light for ,,mmh and ,,sud ,act of #bjbb4 #b4 ,findings ,congress finds the following3 7#a7 ,maternal mental health conditions are the most common complications of pregnancy and childbirth1 affecting #a in #e women or #hjj1jjj women annually1 during pregnancy or the year following pregnancy4 7#b7 ,maternal mental health and substance use disorders contribute to the high rate of maternal mortality in the ,united ,states1 with suicide and drug overdose combined being the leading cause of death for women in the first year following pregnancy4 7#c7 ,women who experience racial and economic inequities are #c to #d times more likely to be impacted by maternal mental health and other behavioral health disorders4 7#d7 ,untreated maternal mental health conditions and substance use disorders can have long-term negative impacts on the mother1 baby1 family1 and society4 7#e7 ,mothers with untreated mental health conditions during pregnancy are more likely to have poor nutrition and struggle with substance use disorders1 which can lead to poor birth outcomes for the baby4 7#f7 ,untreated maternal mental health conditions and substance use disorders can contribute to-- 7,a7 impaired parent-child interactions2 7,b7 behavioral1 cognitive1 or emotional delays in the child2 and 7,c7 adverse childhood experiences that can negatively impact the child's life4 7#g7 ,untreated maternal mental health conditions are estimated to cost the ,united ,states economy #ad1jjj1jjj1jjj or #cb1jjj per mother-infant pair every year in addressing poor health outcomes and accounting for lost wages and productivity of the mother4 7#h7 ,although the ,united ,states ,preventive ,services ,task ,force and several national medical organizations encourage health care providers to screen and treat maternal mental health conditions1 #ge percent of women impacted remain untreated4 7#i7 ,frontline providers who care for women during pregnancy and the first year following pregnancy are often reluctant to screen for maternal mental health conditions1 citing lack of education1 insurance reimbursement1 and resources for affected women4 #c4 ,screening and treatment for a maternal mental health and substance use disorders 7a7 ,in general ,section #cag,l-#a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ac;a7 is amended-- 7#a7 in the section heading1 by striking maternal depression and inserting maternal mental health and substance use disorders2 and 7#b7 in subsection 7a7-- 7,a7 by inserting 1 ,indian ,tribes and ,tribal organizations 7as such terms are defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act71 and urban ,indian organizations 7as such term is defined in section #d of the ,indian ,health ,care ,improvement ,act7 after ,states2 and 7,b7 by striking for women who are pregnant1 or who have given birth within the preceding #ab months1 for maternal depression and inserting for women who are postpartum1 pregnant1 or have given birth within the preceding #ab months1 for maternal mental health and substance use disorders4 7b7 ,application ,subsection 7b7 of section #cag,l-#a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ac;a7 is amended-- 7#a7 by striking a ,state shall submit and inserting an entity listed in subsection 7a7 shall submit2 and 7#b7 in paragraphs 7#a7 and 7#b71 by striking maternal depression each place it appears and inserting maternal mental health and substance use disorders4 7c7 ,priority ,subsection 7c7 of section #cag,l-#a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ac;a7 is amended-- 7#a7 by striking may give priority to ,states proposing to improve or enhance access to screening and inserting the following3 shall give priority to entities listed in subsection 7a7 that-- 7#a7 are proposing to create1 improve1 or enhance screening1 prevention1 and treatment 2 7#b7 by striking maternal depression and inserting maternal mental health and substance use disorders2 7#c7 by striking the period at the end of paragraph 7#a71 as so designated1 and inserting a semicolon2 and 7#d7 by inserting after such paragraph 7#a7 the following3 7#b7 are currently partnered with1 or will partner with1 a community-based organization to address maternal mental health and substance use disorders2 7#c7 are located in an area with high rates of adverse maternal health outcomes or significant health1 economic1 racial1 or ethnic disparities in maternal health and substance use disorder outcomes2 and 7#d7 operate in a health professional shortage area designated under section #ccb4 4 7d7 ,use of funds ,subsection 7d7 of section #cag,l-#a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ac;a7 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 in subparagraph 7,a71 by striking to health care providers2 and and inserting on maternal mental health and substance use disorder screening1 brief intervention1 treatment 7as applicable for health care providers71 and referrals for treatment to health care providers in the primary care setting and nonclinical perinatal support workers22 7,b7 in subparagraph 7,b71 by striking to health care providers1 including information on maternal depression screening1 treatment1 and followup support services1 and linkages to community-based resources2 and and inserting on maternal mental health and substance use disorder screening1 brief intervention1 treatment 7as applicable for health care providers7 and referrals for treatment1 followup support services1 and linkages to community-based resources to health care providers in the primary care setting and clinical perinatal support workers2 and2 and 7,c7 by adding at the end the following3 7,c7 enabling health care providers 7such as obstetrician-gynecologists1 nurse practitioners1 nurse midwives1 pediatricians1 psychiatrists1 mental and other behavioral health care providers1 and adult primary care clinicians7 to provide or receive real-time psychiatric consultation 7in-person or remotely71 including through the use of technology-enabled collaborative learning and capacity building models 7as defined in section #ccj,n71 to aid in the treatment of pregnant and postpartum women2 and 2 and 7#b7 in paragraph 7#b7-- 7,a7 by striking subparagraph 7,a7 and redesignating subparagraphs 7,b7 and 7,c7 as subparagraphs 7,a7 and 7,b71 respectively2 7,b7 in subparagraph 7,a71 as redesignated1 by striking and at the end2 7,c7 in subparagraph 7,b71 as redesignated-- 7i7 by inserting 1 including before for rural areas2 and 7ii7 by striking the period at the end and inserting a semicolon2 and 7,d7 by inserting after subparagraph 7,b71 as redesignated1 the following3 7,c7 providing assistance to pregnant and postpartum women to receive maternal mental health and substance use disorder treatment1 including patient consultation1 care coordination1 and navigation for such treatment2 7,d7 coordinating with maternal and child health programs of the ,federal ,government and ,state1 local1 and ,tribal governments1 including child psychiatric access programs2 7,e7 conducting public outreach and awareness regarding grants under subsection 7a72 7,f7 creating multi-,state consortia to carry out the activities required or authorized under this subsection2 and 7,g7 training health care providers in the primary care setting and nonclinical perinatal support workers on trauma-informed care1 culturally- and linguistically-appropriate services1 and best practices related to training to improve the provision of maternal mental health and substance use disorder care for racial and ethnic minority populations1 including with respect to perceptions and biases that may affect the approach to1 and provision of1 care4 4 7e7 ,additional provisions ,section #cag,l-#a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ac;a7 is amended-- 7#a7 by redesignating subsection 7e7 as subsection 7g72 and 7#b7 by inserting after subsection 7d7 the following3 7e7 ,technical assistance ,the ,secretary shall provide technical assistance to grantees and entities listed in subsection 7a7 for carrying out activities pursuant to this section4 7f7 ,dissemination of best practices ,the ,secretary1 based on evaluation of the activities funded pursuant to this section1 shall identify and disseminate evidence-based or evidence-informed best practices for screening1 assessment1 and treatment services for maternal mental health and substance use disorders1 including culturally- and linguistically-appropriate services1 for women during pregnancy and #ab months following pregnancy4 4 7f7 ,authorization of appropriations ,subsection 7g7 of section #cag,l-#a 7#db ,u4,s4,c4 #bdg;b-#ac;a7 of the ,public ,health ,service ,act1 as redesignated1 is further amended-- 7#a7 by striking #e1jjj1jjj and inserting #bd1jjj1jjj2 and 7#b7 by striking #bjah through #bjbb and inserting #bjbc through #bjbh4 #d4 ,maternal mental health hotline ,part ,p of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g et seq47 is amended by adding at the end the following3 #cii,v-#g4 ,maternal mental health hotline 7a7 ,in general ,the ,secretary shall maintain1 directly or by grant or contract1 a national hotline to provide emotional support1 information1 brief intervention1 and mental health and substance use disorder resources to pregnant and postpartum women at risk of1 or affected by1 maternal mental health and substance use disorders1 and to their families or household members4 7b7 ,requirements for hotline ,the hotline under subsection 7a7 shall-- 7#a7 be a #bd_/g real-time hotline2 7#b7 provide voice and text support2 7#c7 be staffed by certified peer specialists1 licensed health care professionals1 or licensed mental health professionals who are trained on-- 7,a7 maternal mental health and substance use disorder prevention1 identification1 and intervention2 and 7,b7 providing culturally- and linguistically-appropriate support2 and 7#d7 provide maternal mental health and substance use disorder assistance and referral services to meet the needs of underserved populations1 individuals with disabilities1 and family and household members of pregnant or postpartum women at risk of experiencing maternal mental health and substance use disorders4 7c7 ,additional requirements ,in maintaining the hotline under subsection 7a71 the ,secretary shall-- 7#a7 consult with the ,domestic ,violence ,hotline1 ,national ,suicide ,prevention ,lifeline1 and ,veterans ,crisis ,line to ensure that pregnant and postpartum women are connected in real-time to the appropriate specialized hotline service1 when applicable2 7#b7 conduct a public awareness campaign for the hotline2 and 7#c7 consult with ,federal departments and agencies1 including the ,centers of ,excellence of the ,substance ,abuse and ,mental ,health ,services ,administration and the ,department of ,veterans ,affairs1 to increase awareness regarding the hotline4 7d7 ,annual report ,the ,secretary shall submit an annual report to ,congress on the hotline under subsection 7a7 and implementation of this section1 including-- 7#a7 an evaluation of the effectiveness of activities conducted or supported under subsection 7a72 7#b7 a directory of entities or organizations to which staff maintaining the hotline funded under this section may make referrals2 and 7#c7 such additional information as the ,secretary determines appropriate4 7e7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjbc through #bjbh4 4