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ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
AMENDED
postpartum depression; treatment; insurers
(NOW: postpartum depression; education materials)
Purpose
Requires the Department of Health Services (DHS) to compile relevant educational materials and information regarding maternal mental health conditions, including postpartum depression, for use by health care institutions, health care professionals and patients and to establish an Advisory Committee on Obstetrics, Gynecology and Maternal Mental Health in Rural Communities (Advisory Committee).
Background
During and after pregnancy, it is common for women to experience symptoms of depression, anxiety and other mental health conditions. For some women, these symptoms may be limited to only a few days after birth. However, for other women, the symptoms may be far more severe, last much longer and even interfere with the woman's ability to care for her child or self. Although it may begin during or after pregnancy, this is known as postpartum depression. Postpartum depression symptoms include depressed mood or severe mood swings, excessive crying, difficulty bonding with the baby, withdrawal from loved ones, insomnia and feelings of worthlessness, shame, guilt or inadequacy. When left untreated, postpartum depression may last for months or years and can result in severe consequences for the mother and baby alike (Mayo Clinic).
A health care institution is every place, institution, building or agency, whether organized for profit or not, that provides facilities with medical services, nursing services, behavioral health services, health screening services, other health-related services, supervisory care services, personal care services or directed care services and includes home health agencies, outdoor behavioral health care programs and hospice service agencies. A primary care physician is a physician who is a family practitioner, general practitioner, pediatrician, general internist, obstetrician or gynecologist. A primary care practitioner means a nurse practitioner, certified nurse midwife or a physician assistant (A.R.S. ยงยง 36-401 and 36-2901).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
Maternal Mental Health Materials
1. Requires DHS to identify and compile relevant educational materials and information for health care professionals and patients regarding maternal mental health conditions, including postpartum depression, that have been developed by organizations with expertise in maternal mental health conditions.
2. Requires the materials to:
a) be developed by organizations with expertise in maternal mental health conditions; and
b) include information on the symptoms and methods of coping with postpartum depression, as well as treatment options and resources.
3. Requires DHS, if unable to identify existing materials, to develop written educational materials and information, taking into consideration relevant clinical practice guidelines, peer-reviewed studies and recommendations from experts in maternal mental health care, including:
a) The Centers for Disease Control and Prevention; and
b) professional associations and advocacy groups.
4. Directs DHS to post the maternal mental health care materials and information on its public website and to make available or distribute the materials in physical form on request.
5. Requires DHS to periodically review the materials and information to determine their accuracy and insure they reflect the most up-to-date and accurate information.
6. Instructs health care institutions to provide each departing new parent and other new family members, as appropriate, with the written materials and information upon discharge.
7. Requires health care institutions, primary health care professionals and any other health care professionals who render prenatal, postnatal or pediatric infant care to provide the maternal mental health materials and information to any woman who learns she is pregnant or presents with signs of a maternal mental health disorder at any time during pregnancy or postpartum period.
Advisory Committee
8. Requires DHS to establish an Advisory Committee to develop recommendations to ensure the availability of obstetrics, gynecology and maternal mental health services in low-volume, high-risk rural communities.
9. Instructs the Director of DHS to appoint the following members to the Advisory Committee:
a) one representative of a statewide association of hospitals that convenes an alliance for innovation on maternal health;
b) one representative of a critical access hospital that offers maternity care services, including labor and delivery;
c) one representative of a critical access hospital that does not offer maternity care services;
d) one member representing a hospital system in a county with fewer than 1,500,000 persons that delivered more than 10 percent of the infants born in Arizona in 2024;
e) one licensed physician who specializes in obstetrics and gynecology;
f) one licensed physician who specializes in obstetrics and gynecology and whose practice includes maternity care for patients who are transported from one or more rural communities;
g) one licensed physician who specializes in family medicine;
h) one licensed physician who specializes in emergency medicine;
i) one certified nurse midwife;
j) one certified doula;
k) one representative of a federally qualified community health center that administers a rural maternity and obstetrics management strategies program;
l) one representative of an Indian health service facility or a tribal 638 facility that does not offer maternity care services;
m) two representatives of different health care insurers that offer insurance products that include coverage for obstetrics, gynecology and maternal mental health services;
n) one representative of an emergency air ambulance provider that serves a rural community; and
o) one representative of the statewide perinatal psychiatry access line.
10. Requires the health professional members of the Advisory Committee to currently work in a health care practice that provides maternity care services in rural communities.
11. Requires the Directors of DHS, the Arizona Health Care Cost Containment System and the Department of Insurance and Financial Institutions, or their designees, to serve as nonvoting members of the Advisory Committee.
12. Specifies that Advisory Committee members are not eligible to receive compensation or reimbursement of expenses.
13. Directs the Advisory Committee to develop recommendations to enhance:
a) and preserve the delivery and access of preconception, prenatal, pregnancy, labor and delivery, maternal mental health and postpartum care services in rural hospitals and rural communities; and
b) the delivery of and access to evidence-based postpartum depression screening and referrals for treatments, including recommendations that consider public and private insurance coverage, provider reimbursement incentives and pharmacological treatment options.
14. Requires, by December 31, 2026, the Advisory Committee to submit a report of its findings to the Governor, President of the Senate, Speaker of the House of Representatives and the Secretary of State.
15. Allows the Advisory Committee to hold hearings and take testimony from stakeholders and affected persons, including members of the public.
16. Repeals the Advisory Committee on July 1, 2027.
Miscellaneous
17. Defines health care institution, primary care physician and primary care practitioner.
18. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Requires DHS to establish an Advisory Committee to develop recommendations to ensure the availability of obstetrics, gynecology and maternal mental health services in low-volume, high-risk rural communities.
2. Prescribes Advisory Committee membership and duties.
House Action Senate Action
HHS 2/19/25 W/D HHS 3/12/25 DPA 6-0-1
APPROP 2/24/25 DPA 18-0-0-0
3rd Read 3/3/25 55-3-2
Prepared by Senate Research
March 17, 2025
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