HB 6900, An Act Establishing A Task Force To Study Child Development And Perinatal Depression Screening Tools And Data Sharing Systems

TESTIMONY OF CONNECTICUT HOSPITAL ASSOCIATION
SUBMITTED TO THE CHILDREN’S COMMITTEE

Thursday, February 13, 2025

The Connecticut Hospital Association (CHA) appreciates this opportunity to submit testimony concerning HB 6900, An Act Establishing A Task Force To Study Child Development And Perinatal Depression Screening Tools And Data Sharing Systems. CHA supports this bill but recommends the inclusion of hospital representatives on the task force.

Connecticut hospitals and health systems care for patients, strengthen the state’s economy, and support vulnerable communities across the state. Every day, they work to improve healthcare access, affordability, and health equity. Even as they face ongoing challenges, hospitals provide world-class care to everyone who walks through their doors, regardless of their ability to pay. Hospitals also support an exemplary workforce as the largest collective employer in the state, contribute significantly to the state’s economy, and invest in their communities addressing social drivers of health.

HB 6900 bill calls for establishing a task force to study child development and perinatal depression screening tools and data sharing systems. We agree with the need for a task force, which provides a forum to examine guidelines for child development and maternal perinatal screening and data-sharing systems. It also provides the opportunity to explore gaps in the current system, advocate for the standardization of practices across different healthcare settings, and enhance collaboration between cross-system entities to promote the well-being of families. In light of their role in the provision of perinatal and pediatric services, we recommend that a hospital representative be included in the list of providers represented on this task force.

The American Academy of Pediatricians (AAP) as well as the American Academy of Family Physicians (AAFP) recommend the use of standardized screening tools to ensure early detection and intervention for both developmental delays and maternal perinatal depression. Both the AAP and AAFP guidelines support (1) combining both the developmental physical surveillance by a pediatrician and a standardized screening at 9, 18, and 24 or 30 months and (2) using validated screening tools to screen mothers for postpartum depression at the 1-2-month, 3-month, 4-month, and 6-month well-child visits.

Despite these recommendations and the availability of validated screening tools, there are barriers that limit the consistency of use by providers, such as time constraints, insufficient training, and lack of reimbursement. In the United States, the prevalence of children with at least one developmental delay is 15%, and only 3% of these children with developmental delays receive early intervention services before the age of 3. Receiving appropriate support and services is associated with improvement in cognitive and academic performance, especially in high-risk children.

Screening rates for maternal perinatal depression in the U.S. are relatively low, and efforts to improve these rates include the integration of screening of mothers during pediatric well-child visits. Screening rates are highest during the first trimester and trend down over the course of the pregnancy. While most clinicians screen for maternal perinatal depression during the 6-week postpartum visit, the risk for postpartum depression is highest after that time period. Integrating screening with pediatric visits extends the opportunity to detect and address a problem significantly. Appropriate follow-up and referral for mothers with perinatal depression is critical when there is a positive screen for depression and so we must improve access to mental health services and equip providers with information about such resources.

Web-based data sharing can help address follow-up and referral challenges across systems such as healthcare, housing, education, and child welfare, as it can provide a comprehensive view of families’ needs and remove barriers to services. Issues related to patient privacy and data security should be studied and addressed. The task force should study the data assets that currently exist to support families and work to identify and recommend enhanced guidelines to foster information sharing, promote cross-system collaboration, and efficiently use data to support care coordination efforts.

Thank you for your consideration of our position. For additional information, contact CHA Government Relations at (203) 294-7301.