The third proposal of Governor Kathy Hochul’s 2024 State of the State unveiled Thursday is a six-point plan to combat maternal and infant mortality in New York. Recent CDC statistics revealed an increase in infant mortality – for the first time in over two decades. To address this crisis, Governor Kathy Hochul said she will introduce new policies and legislation to expand access to high-quality prenatal care, reduce costs for mothers and families, fight postpartum depression, and support infants in the first months of their lives.
Creating First-In-The-Nation Statewide Paid Prenatal Leave
Governor Hochul will expand New York’s nation-leading statewide Paid Family Leave policy (PFL) to include 40 hours of paid leave to attend prenatal medical appointments – making New York the first state in the nation to establish statewide coverage for prenatal care. Studies show that prenatal health care is highly correlated with improved health outcomes for mothers and infants; pregnant mothers who have access to regular prenatal medical visits are less likely to die in childbirth and their newborns are more likely to be healthy.
Under New York’s current paid family leave law, short-term disability benefits are not available until 4 weeks before the child’s birth after a seven-day waiting period. Adding prenatal care as a separate qualifying event under PFL will enable pregnant workers to ensure their medical needs are met without sacrificing their ability to support the household, or paid leave available for bonding following the birth.
This builds on Governor Hochul’s recent actions to support new parents and improve maternal health outcomes including offering 12 weeks of fully paid parental leave benefits to more than 80 percent of the state workforce and extending postpartum coverage for up to a full year after the end of a pregnancy for Medicaid and Child Health Plus enrollees.
Expanding Access To Doula Care Through Standing Order
Governor Hochul will introduce legislation in her Executive Budget that would enable the Commissioner of Health to issue a “standing order” allowing New Yorkers to utilize doula services without a referral from a physician. Doulas are birthing experts who provide physical, emotional and informational support before, during, and after the child-birthing experience. By issuing a “standing order” for doula coverage, New York will eliminate an unnecessary hurdle for pregnant mothers to cross, especially low-income mothers who rely on Medicaid for health insurance coverage.
In last year’s budget, Governor Hochul secured doula coverage for Medicaid enrollees in New York, a change which took effect earlier this week on January 1. She also signed a new law creating the first New York State directory of doulas.
Eliminate Co-Pays And Other Out-Of-Pocket Costs For Essential Plan And Qualified Health Plans
To reduce barriers to access for maternal and infant health care, Governor Hochul will eliminate cost-sharing – including co-pays and other out-of-pocket costs – for pregnancy-related benefits for any New Yorker enrolled in the Essential Plan or Qualified Health Plans. Governor Hochul will also expand coverage for doulas within the Essential Plan.
Even for New Yorkers with robust health insurance coverage, co-pays and other cost-sharing are significant barriers that prevent pregnant and postpartum individuals from getting the care they need. While the approximately 7 million New Yorkers on Medicaid already benefit from low to no cost-sharing, approximately 1.3 million New Yorkers enrolled in the Essential Plan and Qualified Health Plans still face cost barriers to accessing routine pregnancy-related care.
New Oversight Mechanisms To Avoid Unnecessary C-Sections
Cesarean births (or C-Sections) should be utilized only when the procedure is determined to be the best approach for the mother or the baby. However, some doctors perform these surgeries more frequently than clinical best practices recommend. While this can be for a variety of reasons, one factor is that it is often more profitable to perform a C-section, even when doing so is not necessary for the patient.
To address this critical issue, Governor Hochul has directed the Department of Health to launch new initiatives to reduce the rate of unnecessary C-sections. This will include new oversight measures to identify physicians whose behavior is out of line with clinical best practices, allowing the Department of Health to hold providers – including those overutilizing C-sections – accountable. It also includes a new Medicaid financial incentives for hospitals to reduce the number of unnecessary C-sections.
Address Maternal Mental Health And Post-partum Depression
According to CDC data, approximately one in five pregnancy-related deaths (23 percent) are due to mental health conditions, and approximately one in eight women who have recently given birth experience postpartum depression. Maternal mental health conditions rank among the leading causes of maternal mortality in New York.
New York will train counselors answering the 988 Suicide and Crisis Lifeline on issues related to maternal mental health, postpartum depression, and anxiety. This specialized training will ensure counselors will provide the compassionate care, support, and resources necessary to help mothers and birthing parents experiencing mental health distress. Starting in 2022, Governor Hochul helped successfully implement the 988 Suicide and Crisis Lifeline –formerly called the National Suicide Prevention Lifeline –throughout the state.
In addition, Project TEACH’s Maternal Mental Health initiative will expand to include support for additional patient-facing professions, such as therapists, lactation consultants, WIC staff, home visiting nurses, and other frontline practitioners so they may receive specialized training and access expert consultation to provide mental health support to the pregnant and postpartum New Yorkers they assist. This initiative is part of an existing training resource aimed at increasing treatment efficacy among prescribers, including general psychiatrists, primary care doctors, nurse practitioners, OB-GYNs, and others who may lack adequate maternal mental health expertise.
Reducing The Risk Of Sudden Unexpected Infant Deaths (SUID)
Unsafe sleep deaths are the most common type of preventable child fatalities that come to the attention of state officials. Each week, roughly two infants die in an unsafe sleep setting, resulting in more than 120 infant deaths per year. Sometimes this is due to a lack of access to safety-approved cribs, particularly for low-income families.
Since safe sleep environments are crucial for reducing the risk of sleep-related deaths, Governor Hochul will provide funding for the distribution of portable cribs for under-resourced New Yorkers at no cost. The cribs would be available to families via local county departments of social services and other local organizations. Medical professionals at birthing hospitals will also facilitate referrals where a need for a crib is identified.
