Community health centers will be eligible for grants in 2012 (as they were in 2011) to the tune of $3 million for inpatient and outpatient counseling and services.
And a federal public awareness campaign will educate the public through radio and television ads.
These endeavors point to the need for ObGyns to familiarize themselves with postpartum depression—if they aren’t already well versed in the subject—because patients are likely to become more aware of this issue and look to their ObGyns for answers.
6. Maternal home visits
Congress established a new Maternal, Infant, and Early Childhood Home Visiting program to improve maternal and fetal health in underserved areas of our country. This program will provide funds to states, tribes, and territories to develop and implement evidence-based home-visitation models to reduce infant and maternal mortality and its causes by producing improvements in:
- prenatal, maternal, and newborn health
- child health and development
- parenting skills
- school readiness
- juvenile delinquency
- family economic self-sufficiency.
These programs will have to demonstrate effectiveness and improved outcomes. HHS recently requested suggestions on ways of demonstrating the effectiveness of home-visiting program models for pregnant women, expectant fathers, and caregivers of children from birth through entry into kindergarten.
The law appropriates $350 million to this program in 2012 and $400 million in both 2013 and 2014.
7. Assistance for pregnant students
A new Pregnancy Assistance Fund—$25 million annually over 10 years (fiscal years 2010–2019)—requires the Secretary of HHS (in collaboration with the Secretary of Education) to establish a state grant program to help pregnant and parenting teens and young women. The aim of this program is to help teens who become pregnant and who choose to bring their pregnancies to term or keep their babies, or both, to stay in school. Grants will go to institutions of higher education, high schools and community service centers, as well as state attorneys general.
Institutions that receive grants must work with providers to meet specific practical needs of pregnant or parenting students:
- housing
- childcare
- parenting education
- postpartum counseling
- assistance in finding and accessing needed services
- referrals for prenatal care and delivery, infant or foster care, or adoption.
Funds to attorneys general will be used to combat domestic violence among pregnant teens.
8. Young women's breast cancer
A new program is intended to help educate young women about the importance of breast health and screening, in two ways:
- The National Institutes of Health (NIH) will conduct research to develop and test screening measures for prevention and early detection of breast cancer in women 15 to 44 years old.
- The US Department of HHS will create a national awareness campaign, with $9 million in funding each year from 2010 to 2014, to encourage young women to talk with their doctors about breast cancer and early detection.
ObGyns can expect to see more interest and questions about breast health among young women and their mothers. It pays to be prepared with good information for these important conversations.
9. Personal responsibility education
From 2010 through 2014, each state will receive funds for personal responsibility education programs aimed at reducing pregnancy in youths. Funds are $75 million for each fiscal year, allocated to each state depending on the size of its youth population but not intended to be less than $250,000 per state.
Educational programs eligible for federal funds must include both abstinence and contraception information for prevention of teenage pregnancy and sexually transmitted infections, including HIV/AIDS, as well as three or more adulthood-preparation subjects.
10. Community-based support of Patient-Centered Medical Homes
Federal funding is available to states for the development of community-based health teams to support medical homes run by primary care practices. These teams may include specialists, nurses, pharmacists, nutritionists, dieticians, social workers, behavioral and mental health providers, and physician assistants. Primary care practices in this program function as medical homes and are responsible for addressing a patient’s personal health-care needs. The team links the medical home to community support services for its patients.
Eligible ObGyn practices can qualify as primary care practices, and ObGyns are eligible to serve as specialist members of the community-based health team.
ACA is a mixed bag for ObGyns
Women have much to gain from the provisions of the ACA. It’s also true that many parts of the law are terrible for practicing ObGyns, including the Independent Payment Advisory Board (IPAB) and the absence of meaningful medical liability reform. For more on these issues, see “Is private ObGyn practice on its way out?” which appears in the October 2011 issue of OBG Management (available in the archive at obgmanagement.com). ACOG is committed to working with Congress to repeal or remedy those aspects of the law.