Governor Andrew M. Cuomo today announced new efforts to combat maternal depression and prevent maternal mortality in New York State. The Governor will direct the Department of Financial Services to require all health insurance policies include coverage for maternal depression screening, and will launch a new Maternal Mortality Review Board. The announcements come as New York is ranked 30th in the nation for maternal mortality rates, and are part of Governor Cuomo's 2018 Women's Agenda for New York: Equal Rights, Equal Opportunity and the FY 2019 Executive Budget.
"New York is committed to ensuring that women receive high quality health care at every stage of their lives, and with these new, comprehensive efforts, we are once again taking action to break down barriers to health care access and provide skillful and compassionate care to all New Yorkers," Governor Cuomo said. "These initiatives will work to correct unacceptable racial disparities in health outcomes, provide critical support to new and expecting parents, and help ensure a healthier and stronger New York for all."
Lieutenant Governor and Chair, New York Women's Suffrage Commission, Kathy Hochul said, "The United States has among the worst outcomes for mothers compared to other developed countries. Governor Cuomo's proposals will ensure New York moms have access to the health care - including mental health care - they deserve during pregnancy, birth, and the post-partum period. Screenings are the first step towards improving the lives of mothers and their children."
Secretary to the Governor and Chair, New York State Council on Women and Girls, Melissa DeRosa said, "2017 will go down in history as the year when women spoke up and drew a line in the sand, and 2018 will be the year that society needs to respond. With this commonsense legislation, Governor Cuomo once again stands with women to advance their equality, opportunity, and safety. With these actions, we are further improving women's healthcare and making New York a safer state for all."
Launch Multi-Agency Effort to Combat Maternal Depression
As a champion for New York's children and families, Governor Cuomo recognizes the critical difference skillful, prompt and compassionate care can mean for women with maternal depression, which affects as many as one in seven mothers nationally. Screening increases detection, diagnosis and intervention for maternal depression, which is highly treatable if identified early.
But too many front-line health care providers lack sufficient training to treat post-partum depression, too many women lack access to information about available services and stigma is a barrier between families and the mental health services they may need.
To strengthen and support the ability of New York's health care providers to deliver care to mothers experiencing maternal depression, Governor Cuomo will advance an aggressive strategy to ensure that all new mothers have access to screening and treatment.
First, the Governor will direct the Department of Financial Services to require that all health insurance policies issued in the State include coverage for maternal depression screening by both adult and pediatric primary care providers, as well as speedy referrals to treatment specialists. Insurance policies that cover the child but not the parent, must provide coverage for maternal depression screening, as a critically important preventative care intervention for the health of the child. This directive will build upon additional measures to expedite referrals and treatment, including expansion of Project TEACH to connect primary care providers with mental health specialists, enhanced screening and referrals at WIC clinics and increased access to telepsychiatry for those in rural communities.
Second, the Governor will direct the Department of Health and the Office of Mental Health to launch a strategic awareness campaign to provide critical information about symptoms and treatment options, and to more broadly remove the stigma associated with maternal depression.
Third, the Governor will direct OMH to advance cutting-edge specialty programs to treat maternal depression, including a mother-baby inpatient unit and outpatient programs that focus on maternal depression.
Collectively, these efforts will strengthen the capacity of providers to address the mental health concerns of their pregnant and postpartum patients, so that women at risk or already suffering from maternal depression will have better health and access to care.
Establish the Maternal Mortality Review Board to Save Lives
The Department of Health implemented the Maternal Mortality Review and Prevention Initiative in 2010 to review all maternal deaths with the goal of ensuring a comprehensive review of factors leading to maternal deaths in New York State. The MMR committee is comprised of clinicians and other key stakeholders from professional organizations and hospitals to review aggregate data and provide recommendations for prevention and improvements in medical care and to identify focus areas for education and quality improvement.
Although the initiative has led to improvements in reducing maternal mortality rates since 2010, New York State still ranks 30th in the nation for lowest maternal mortality rate. Moreover, staggering racial disparities persist, as African American women are almost four times more likely to die in childbirth than white women.
In an effort to protect families and prevent future maternal deaths, DOH will form a Maternal Mortality Review Board that will implement an enhanced multidisciplinary analysis of each and every maternal death in the New York State and to develop actionable recommendations to improve maternal outcomes and clinical care. The MMR Board will also be tasked with developing recommendations to the Commissioner of Health on strategies to address Severe Maternal Morbidity and racial disparities.
DOH is partnering with the American College of Obstetricians and Gynecologists and other maternal health partners, including the Healthcare Association of New York State, Greater New York Hospital Association and the New York Academy of Medicine, to guide the implementation of the MMR Board, which will be comprised of leading clinical experts.
Department of Financial Services Superintendent Maria Vullo said, "DFS is committed to ensuring that mothers struggling with maternal depression receive the screening and treatment they and their families need. Clinical findings have repeatedly shown there is a distinct connection between maternal depression and an increased level of emotional and functional problems in infants, prepubescent, adolescent and adult children. DFS supports families in securing the health insurance coverage they deserve."
New York State Office of Mental Health Commissioner Dr. Ann Sullivan said, "Maternal depression affects as many as 1 in 7 new mothers, and has an impact on the child and the entire family, as well as the mother. The good news is maternal depression is highly treatable if identified early. Governor Cuomo's new initiatives will encourage screenings for maternal depression, assist healthcare providers to better detect and diagnose this problem and help new mothers to recover."
New York State Department of Health Commissioner Dr. Howard Zucker said, "Far too many women lose their lives due to avoidable complications during pregnancy and these deaths are unacceptably high in African-American communities. Under Governor Cuomo's direction, New York State is striving to ensure that all women have access to vital health care services during pregnancy and is undertaking a comprehensive review of clinical and systemic factors leading to maternal mortality. No matter who or where they are, New York women should know they are not alone during or after pregnancy."
Christy Turlington Burns, CEO & Founder, Every Mother Counts, said, "Following a childbirth related complication after the birth of my first child, I knew I wanted to do all I could to prepare and support other mothers throughout pregnancy and childbirth. I founded Every Mother Counts to raise awareness about preventable maternal deaths and disabilities, with a mission to make safe and respectful maternity care accessible for every mother, everywhere. I've travelled the world to learn about the challenges and solutions to support and promote safe motherhood. This global tragedy is also a problem here in the U.S. where maternal mortality is on the rise nationally and in my hometown of New York City. That's why I look forward to working with Governor Cuomo on this important and critical initiative."
American College of Obstetricians and Gynecologists District II Chair Dr. Iffath Abbasi Hoskins said, "ACOG District II is pleased to partner with the Department of Health on this important initiative to address maternal mortality in our State. Development of a review board is critical to facilitating timely data analysis in order to develop actionable prevention strategies. We look forward to sharing updates with the state's network of ob-gyn doctors to improve the quality of care provided, and thus decrease maternal deaths in NY State."
Schuyler Center for Analysis and Advocacy President and CEO Kate Breslin said, "Postpartum depression is the most common complication associated with childbirth; it is a problem for moms and, untreated, can have a permanent impact on their children. It is certainly in the best interest of all New Yorkers to prevent, detect and treat maternal depression."New York Medical College Associate Professor and Dean Camille A. Clare MD MPH CPE FACOG, said, "Stark racial disparities in maternal mortality exist in NYS with black women dying at a rate of three and a half times that of white women. I commend Governor Cuomo for prioritizing maternal mortality and morbidity which have wide-ranging consequences for women, families and communities in New York. All women deserve equity and equality in the care they receive."