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HOUSE DOCKET, NO. 2965 FILED ON: 1/19/2023
HOUSE . . . . . . . . . . . . . . . No. 1984
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Brandy Fluker Oakley
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to expand equitable perinatal mental health services.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Brandy Fluker Oakley12th Suffolk1/19/2023Lindsay N. Sabadosa1st Hampshire1/19/2023Bud L. Williams11th Hampden1/20/2023Sean Garballey23rd Middlesex1/24/2023Steven Owens29th Middlesex1/24/2023Carmine Lawrence Gentile13th Middlesex1/25/2023Michelle L. Ciccolo15th Middlesex1/25/2023Danillo A. Sena37th Middlesex1/25/2023James J. O'Day14th Worcester1/26/2023Jessica Ann Giannino16th Suffolk1/27/2023James K. Hawkins2nd Bristol1/27/2023Josh S. Cutler6th Plymouth1/27/2023Samantha Montaño15th Suffolk1/31/2023Mindy Domb3rd Hampshire1/31/2023Michael P. Kushmerek3rd Worcester2/2/2023William C. Galvin6th Norfolk2/6/2023Ruth B. Balser12th Middlesex2/7/2023Patrick M. O'ConnorFirst Plymouth and Norfolk2/7/2023 2 of 2
Michelle M. DuBois10th Plymouth2/7/2023Thomas M. Stanley9th Middlesex2/10/2023Orlando Ramos9th Hampden2/13/2023Jay D. Livingstone8th Suffolk2/14/2023James Arciero2nd Middlesex2/15/2023Vanna Howard17th Middlesex2/27/2023Patrick Joseph Kearney4th Plymouth2/28/2023Kathleen R. LaNatra12th Plymouth2/28/2023Carlos González10th Hampden3/2/2023Edward R. Philips8th Norfolk3/2/2023Joan B. LovelySecond Essex3/2/2023Jennifer Balinsky Armini8th Essex3/2/2023Shirley B. Arriaga8th Hampden3/2/2023Mary S. Keefe15th Worcester3/2/2023Russell E. Holmes6th Suffolk3/2/2023Margaret R. Scarsdale1st Middlesex3/3/2023Patricia A. Duffy5th Hampden3/8/2023Christopher J. Worrell5th Suffolk3/8/2023Lydia EdwardsThird Suffolk3/9/2023Rodney M. Elliott16th Middlesex3/9/2023 1 of 11
HOUSE DOCKET, NO. 2965 FILED ON: 1/19/2023
HOUSE . . . . . . . . . . . . . . . No. 1984
By Representative Fluker Oakley of Boston, a petition (accompanied by bill, House, No. 1984)
of Brandy Fluker Oakley and others for legislation to expand equitable perinatal mental health
services. Mental Health, Substance Use and Recovery.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
_______________
An Act to expand equitable perinatal mental health services.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 Section 1. Chapter 6A of the General Laws is hereby amended by inserting after section
216CC the following section:-
3 Section 16DD. (a) As used in this section, the following words shall have the following
4meanings:-
5 “Health professional shortage area”, a specific geographic area, specific population group
6or specific facility federally designated as having a critical shortage of primary, dental, or mental
7health care providers.
8 “Medically underserved populations”, federally designated populations that have too few
9primary care providers, high infant mortality, high poverty or high elderly population. 2 of 11
10 “Mental or behavioral health care provider”, a health care provider in the field of mental
11or behavioral health, including substance use disorders, acting in accordance with the laws of the
12commonwealth.
13 “Perinatal”, the period of time from pregnancy up until one year following birth.
14 “Perinatal healthcare desert”, a region where the population has inadequate access to
15 perinatal healthcare.
16 “Perinatal mental and behavioral health care workforce”, mental or behavioral health care
17providers who focus on perinatal health in biological parents, birthing persons, adoptive parents,
18foster parents, and any other individuals involved in the gestation, birth, and custodial care of an
19infant.
20 “Secretary”, the secretary of health and human services.
21 (b) The secretary may award grants to entities to establish or expand programs to grow
22and diversify the perinatal mental and behavioral health care workforce.
23 (c) Recipients of grants under this section shall use the grants to grow and diversify the
24perinatal mental and behavioral health care workforce by:
25 (1) establishing schools or programs that provide education and training to individuals
26seeking appropriate licensing or certification as mental or behavioral health care providers who
27will specialize in perinatal mental health conditions or substance use disorders; or 3 of 11
28 (2) expanding the capacity of existing schools or programs described in paragraph (1) of
29this subsection, for the purposes of increasing the number of students enrolled in those schools or
30programs, including by awarding scholarships for students.
31 (d) In awarding grants under this section, the secretary shall give priority to any entity
32that:
33 (1) has demonstrated a commitment to recruiting and retaining students and faculty from
34medically underserved populations or perinatal health care deserts;
35 (2) has developed a strategy to recruit and retain a diverse pool of students into the
36perinatal mental and behavioral health care workforce program or school supported by funds
37received through the grant, particularly from medically underserved populations;
38 (3) has developed a strategy to recruit and retain students who plan to practice in a health
39professional shortage area;
40 (4) has developed a strategy to recruit and retain students who plan to practice in an area
41with significant racial, ethnic and rural disparities in perinatal health outcomes, to the extent
42practicable;
43 (5) includes in the standard curriculum for all students within the perinatal mental and
44behavioral health care workforce program or school a bias, racism or discrimination training
45program that includes training on implicit bias and racism; or
46 (6) is operated by or employs providers with past lived-experience with perinatal mental
47health conditions or substance use disorders.
48 (e) The period of a grant awarded to an entity under this section shall be up to 5 years. 4 of 11
49 (f) To seek a grant under this section, an entity shall submit to the secretary an
50application at such time, in such manner and containing such information as the secretary may
51require.
52 (g) The secretary shall provide, directly or by contract, technical assistance to entities
53seeking or receiving a grant under this section on the development, use, evaluation and post grant
54period sustainability of the perinatal mental and behavioral health care workforce programs or
55schools proposed, established or expanded through the grant. The secretary shall advertise or
56promote technical assistance for potentially eligible programs to raise awareness about the grants
57and the technical assistance, particularly to encourage small providers to apply.
58 (h) The secretary shall collaborate with the executive office of labor and workforce
59development to develop perinatal mental and behavioral health care workforce standards to
60measure the efficacy of grants awarded pursuant to this section.
61 (i) As a condition of receipt of a grant under this section for a perinatal mental and
62behavioral health care workforce program or school, a recipient of funds shall agree to submit to
63the secretary an annual report on the activities conducted through the grant. The report shall
64include:
65 (1) the number and demographics of students participating in the program or school;
66 (2) the extent to which students in the program or school are entering careers in health
67professional shortage areas designated by the commonwealth, areas with significant racial and
68ethnic disparities in perinatal health outcomes and perinatal health care deserts to the extent such
69data are available; and 5 of 11
70 (3) whether the program or school has included in the standard curriculum for all students
71a bias, racism or discrimination training program that includes training on implicit bias and
72racism, and if so data on perinatal mental and behavioral health care outcomes for patients
73belonging to medically underserved populations who receive treatment from such students.
74 (j) Not later than 4 years after the date of enactment of this section, the secretary shall
75 prepare and submit to the governor, the clerks of the house of representatives and the
76senate, and make publicly available on the department’s website a report on the effectiveness of
77the grant program under this section, including information about:
78 (1) recruiting students from medically underserved populations;
79 (2) increasing the number of mental or behavioral health care providers specializing in
80perinatal mental health conditions or substance use disorders from medically underserved
81populations;
82 (3) increasing the number of mental or behavioral health care providers specializing in
83perinatal mental health conditions or substance use disorders working in health professional
84shortage areas; and
85 (4) increasing the number of mental or behavioral health care providers specializing in
86perinatal mental health conditions or substance use disorders working in areas with significant
87racial and ethnic disparities in perinatal health outcomes, as well as perinatal health care deserts
88and rural areas, to the extent such data are available.
89 (5) supporting and increasing the number of providers with past lived-experience with
90perinatal mental health conditions or substance use disorders. 6 of 11
91 Section 2. Chapter 6A of the General Laws is hereby amended by inserting after section
9216DD the following section:-
93 Section 16EE. (a) As used in this section, the following words shall have the following
94meanings:
95 “Culturally congruent care”, care that is in agreement with the preferred cultural values,
96beliefs, worldview, language and practices of the health care consumer.
97 “Eligible entity”, a: (1) community-based organization serving perinatal individuals,
98including organizations serving individuals from medically underserved populations and other
99underserved populations; (2) non-profit or patient advocacy organization with expertise in
100mental and behavioral health of perinatal individuals; (3) maternity care provider; (4) mental or
101behavioral health care provider who treats mental health conditions or substance use disorders in
102perinatal individuals; (5) public health agencies, including the department of public health or a
103local public health department; (6) federally recognized Indian tribe or tribal organization; (7)
104non-profit organizations with expertise in early relational health; (8) non-profit or community
105organizations serving perinatal individuals experiencing pregnancy or infant loss; or (9) public
106health agencies or non-profit or community organizations providing home visiting services for
107perinatal individuals; or (10) domestic violence shelter.
108 “Freestanding birth center”, a health facility: (1) that is not a hospital; (2) where
109childbirth is planned to occur away from the pregnant person’s residence; (3) that is licensed or
110otherwise approved by the commonwealth to provide prenatal labor and delivery or postpartum
111care; and (4) that complies with other requirements established by the commonwealth relating to
112the health and safety of individuals provided services by the facility. 7 of 11
113 “Maternity care provider”, a health care provider who: (1) is a physician, physician
114assistant, certified nurse-midwife, nurse practitioner or clinical nurse specialist; and (2) has a
115focus on maternal or perinatal health.
116 “Medically underserved populations”, federally designated populations that have too few
117primary care providers, high infant mortality, high poverty or high elderly population.
118 “Mental or behavioral health care provider”, a health care provider in the field of mental
119or behavioral health, including substance use disorders, acting in accordance with the laws of the
120commonwealth.
121 “Perinatal”, the period of time from pregnancy up until one year following birth.
122 “Perinatal individuals”, biological parents, birthing persons, adoptive parents, foster
123parents, and any other individuals involved in the gestation, birth, and custodial care of an infant.
124 “Secretary”, the secretary of health and human services.
125 (b) The secretary shall establish a program to award grants to eligible entities to address
126mental health conditions and substance use disorders with respect to perinatal individuals, with a
127focus on medically underserved populations.
128 (c) To receive a grant under this section an eligible entity shall submit to the secretary an
129application at such time, in such manner and containing such information as the secretary may
130require, including how the entity will use funds for activities described in subsection (e) that are
131culturally congruent.
132 (d) In awarding grants under this section, the secretary shall give priority to an eligible
133entity that: 8 of 11
134 (1) is partnering, or will partner, with a community-based organization to address mental
135health conditions or substance use disorders in perinatal individuals described in subsection (a);
136and
137 (2) is operating in an area with high rates of adverse perinatal health outcomes or
138significant racial or ethnic disparities in perinatal health outcomes.
139 (e) An eligible entity that receives a grant under this section shall use funds for the
140following:
141 (1) establishing or expanding maternity care programs to improve the integration of
142perinatal mental health and behavioral health care services into primary care settings where
143perinatal individuals regularly receive health care services;
144 (2) establishing or expanding group prenatal care programs or postpartum care programs;
145(3) expanding existing programs that improve mental health and behavioral health for perinatal
146individuals, with a focus on perinatal individuals from medically underserved populations;
147 (4) providing services and support for perinatal individuals with perinatal mental health
148conditions and substance use disorders, including referrals to addiction treatment centers that
149offer evidence-based treatment options;
150 (5) addressing stigma associated with perinatal mental health conditions and substance
151use disorders, with a focus on medically underserved populations;
152 (6) raising awareness of warning signs of perinatal mental health conditions and
153substance use disorders, with a focus on perinatal individuals from medically underserved
154populations; 9 of 11
155 (7) establishing or expanding programs to prevent suicide or self-harm among perinatal
156individuals;
157 (8) offering evidence-aligned programs at freestanding birth centers that provide perinatal
158mental and behavioral health care education, treatments, and services, and other services for
159perinatal individuals;
160 (9) establishing or expanding programs to provide education and training to maternity
161care providers with respect to identifying potential warning signs for mental health conditions or
162substance use disorders in perinatal individuals, with a focus on individuals from medically
163underserved populations. In the case where such providers identify such warning signs, offering
164referrals to mental or behavioral health care professionals;
165 (10) publicizing information about health care providers who treat perinatal mental health
166conditions and substance use disorders;
167 (11) establishing or expanding programs in communities to improve coordination
168between maternity care providers and perinatal mental or behavioral health care providers who
169treat mental health conditions and substance use disorders in perinatal individuals, including
170through the use of toll-free hotlines;
171 (12) establishing or expanding programs with services for individuals suffering
172pregnancy or infant loss;
173 (13) establishing or expanding programs with services to address the perinatal risks of
174domestic violence; 10 of 11
175 (14) establishing or expanding programs that provide home visits to address perinatal
176mental health conditions and substance use disorders;
177 (15) establishing or expanding programs that improve early relational health;
178 (16) carrying out other programs aligned with evidence-based practices for addressing
179mental health conditions and substance use disorders for perinatal individuals, with a focus on
180medically underserved populations; or
181 (17) other similar programs.
182 (f) The period of a grant awarded to an entity under this section shall be up to 5 years. .
183 (g) The secretary shall provide, directly or by contract, technical assistance to entities
184seeking or receiving a grant under this section on the development, use, evaluation and post-
185grant period sustainability of the program proposed, established or expanded through the grant.
186The secretary shall advertise or promote technical assistance for potentially eligible programs to
187raise awareness about the grants and the technical assistance, particularly to encourage small
188providers to apply.
189 (h) An eligible entity that receives a grant under this section shall submit annually to the
190secretary, and make publicly available, a report on the activities conducted using funds received
191through a grant under this section. Such reports shall include quantitative and qualitative
192evaluations of such activities, including the experience of perinatal individuals who received
193health care through such grant. 11 of 11
194 (i) Not later than the end of each fiscal year that grants are awarded, the secretary shall
195submit to the governor, the clerks of the house of representatives and the senate, and make
196publicly available on the department’s website a report that includes:
197 (1) a summary of the reports received under subsection (h);
198 (2) an evaluation of the effectiveness of grants awarded under this section;
199 (3) recommendations with respect to expanding coverage of evidence-based screenings
200and treatments for perinatal mental health conditions and substance use disorders; and
201 (4) recommendations with respect to ensuring activities described under subsection (e)
202continue after the end of a grant period.
203 Section 3. The executive office of health and human services in consultation with the
204executive office of labor and workforce development shall promulgate regulations for the
205implementation of sections 16DD and 16EE within 90 days of enactment.