S690

An Act concerning postpartum home visits and supplementing Title 26 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. The Legislature finds and declares:

a. The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being;

b. During this period, a woman is adapting to multiple physical, social, and psychological changes, while simultaneously recovering from childbirth, adjusting to changing hormones, and learning to feed and care for her newborn;

c. Like prenatal care, the postpartum health care visit that typically occurs six weeks after childbirth is considered important to a new mother's health; however, for many women, the six-week postpartum visit punctuates a period devoid of formal or informal maternal support;

d. Additionally, according to the American College of Obstetricians and Gynecologists, as many as 40 percent of women do not attend a postpartum visit in the United States;

e. During the time immediately following delivery, health care providers are uniquely qualified to enable a woman to access the clinical and social resources she needs to successfully navigate the transition from pregnancy to parenthood;

f. Studies regarding the Durham Connects program, which provides postpartum home visits by trained registered nurses to all families in Durham County, North Carolina that have newborns between the ages of two to 12 weeks old, have found that participating families: experience reduced rates of clinical maternal anxiety; have safer and more child-friendly home environments; utilize higher quality child care; have better community connections; exhibit safer and more responsible parenting behaviors; have higher levels of father involvement; and experience a significantly reduced rate of infant emergency medical care;

g. Research also indicates that postpartum education and care lead to lower rates of maternal morbidity and mortality, as many of the risk factors for post-delivery complications, such as hemorrhaging or a pulmonary embolism, may not be identifiable before a woman’s discharge after birth;

h. Such data demonstrate the wide ranging benefits to women, children, and families when a mother and infant receive support from the medical community within days after delivering a child; and

i. It is, therefore, in the public interest for the Legislature to remove barriers regarding access to postpartum care and to establish the infrastructure for New Jersey mothers to receive one cost-free postpartum home visit in which a member of the medical community provides the necessary physical, social, and emotional support critical to recovery following childbirth.

2. a. Each hospital and birthing facility shall:

(1) schedule a postpartum home visit for each pregnant patient who gives birth at the hospital or facility, following the birth of the patient’s infant and prior to the patient’s discharge from the hospital or facility. The postpartum home visit shall be scheduled for a date that is within seven days of the patient’s discharge; and

(2) provide one postpartum home visit for each pregnant patient discharged from the hospital or facility following the birth of the patient’s infant, as scheduled by the hospital or facility pursuant to paragraph (1) of subsection a. of this section.

b. A hospital or birthing facility shall waive the receipt of any copayment, coinsurance, or deductible that may be required from a patient, pursuant to the patient’s contract with a third party payer, for services provided pursuant to subsection a. of this section.

c. Notwithstanding any other law to the contrary, a hospital or birthing facility shall not seek payment from a patient for services provided pursuant to subsection a. of this section, including any remaining balances following payment by an applicable third party payer.

d. The provisions of this section shall not apply if the patient objects to receiving a postpartum home visit for any reason.

e. As used in this section:

"Birthing facility" means an inpatient or ambulatory health care facility licensed by the Department of Health that provides birthing and newborn care services.

“Hospital” means an acute care hospital licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et al.)

“Postpartum home visit” means a home visit to a woman and infant, within the first seven days following delivery, by a licensed healthcare provider to ensure proper recovery from childbirth and includes, but is not limited to: a weight and health check of the newborn; an assessment of the physical wellness of the woman; breastfeeding support; assistance identifying and coping with postpartum depression or other behavioral health concerns; and any referrals for medically necessary follow–up healthcare.

3. The Department of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to implement the provisions of this act.

4. This act shall take effect on the first day of the fourth month next following the date of enactment, but the Commissioner of Health may take such anticipatory administrative action in advance thereof as may be necessary for the implementation of this act.

STATEMENT

This bill provides that New Jersey residents have access to one cost-free postpartum home visit. As defined in the bill, a “postpartum home visit” means a home visit to a woman and infant, within the first seven days following delivery, by a licensed healthcare provider to ensure proper recovery from childbirth and includes, but is not limited to: a weight and health check of the newborn; an assessment of the physical wellness of the woman; breastfeeding support; assistance identifying and coping with postpartum depression or other behavioral health concerns; and any referrals for medically necessary follow–up healthcare.

The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. During this period, a woman is adapting to multiple physical, social, and psychological changes, while simultaneously recovering from childbirth, adjusting to changing hormones, and learning to feed and care for her newborn. Like prenatal care, the postpartum health care visit that typically occurs six weeks after childbirth is considered important to a new mother's health; however, for many women, the six-week postpartum visit punctuates a period devoid of formal or informal maternal support. Additionally, according to the American College of Obstetricians and Gynecologists, as many as 40 percent of women do not attend a postpartum visit in the United States.

During the time immediately following delivery, health care providers are uniquely qualified to enable a woman to access the clinical and social resources she needs to successfully navigate the transition from pregnancy to parenthood. Studies regarding the Durham Connects program, which provides postpartum home visits by trained registered nurses to all families in Durham County, North Carolina that have newborns between the ages of two to 12 weeks old, have found that participating families: experience reduced rates reduced rates of clinical maternal anxiety; have safer and more child-friendly home environments; utilize higher quality child care; have better community connections; exhibit safer and more responsible parenting behaviors; have higher levels of father involvement; and experience a significantly reduced rate of infant emergency medical care. Research also indicates that postpartum education and care lead to lower rates of maternal morbidity and mortality, as many of the risk factors for post-delivery complications, such as hemorrhaging or a pulmonary embolism, may not be identifiable before a woman’s discharge after birth.

Such data demonstrate the wide ranging benefits to women, children, and families when a mother and infant receive support from the medical community within days after delivering a child. It is, therefore, the sponsor’s belief that is in the public interest for the Legislature to remove barriers regarding access to postpartum care and to establish the infrastructure for New Jersey residents to receive one cost-free postpartum home visit in which a member of the medical community provides the necessary physical, social, and emotional support critical to recovery following childbirth.

Specifically, this bill requires each hospital and birthing facility in the State to schedule a postpartum home visit, to take place within seven days of the patient’s discharge, for each pregnant patient who gives birth at the hospital or facility, following the birth of the patient’s infant and prior to the patient’s discharge from the hospital or facility. The hospital or birthing facility must also provide the scheduled postpartum home visit. Under the bill, a hospital or birthing facility will not be required to schedule and conduct a postpartum home visit if the patient objects to receiving the visit for any reason

The bill includes two provisions to ensure that the services provided are cost-free to the patient. First, under the bill, a hospital or birthing facility is directed to waive the receipt of any copayment, coinsurance, or deductible that may be required from a patient, pursuant to the patient’s contract with a third party payer, for services provided pursuant to the bill. Second, a hospital or birth facility is prohibited from seeking payment from a patient for services provided pursuant to the bill, including any remaining balances following payment by an applicable third party payer.