The NCSL Blog


By Erik Skinner

According to author Jess Lair, “Children are not things to be molded, but are people to be unfolded.”

Mother and daughterIt is not often that the world of literature and state legislative policy tracking cross over, but this is one of those times. NCSL’s new Maternal and Child Health Database tracks enacted state policies that support mothers and pregnant women as they navigate their pregnancies and support the physical and emotional health of infants and children, allowing them to grow and “unfold.”

The legislative tracking database, funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau’s Supporting State Maternal and Child Policy Innovations Program, includes more than 400 pieces of legislation enacted in 2018 across 14 important maternal and child health priority areas.

The policy areas include: children’s nutrition, children’s mental health in schools, children’s mental health services, maternal mental health, infant mortality, maternal mortality and morbidity, childhood immunization requirements, newborn screening, children’s oral health, breastfeeding, long-acting reversible contraceptives (LARCs) and oral health during pregnancy.

Whether it is a bill that recognizes the emotional benefits of breastfeeding for the mother or screening for maternal depression during well child visits, the bills in this database often address maternal and child populations simultaneously.

Below are the database’s top three categories by bill volume in 2018 and a summary of the common themes.

Childhood Nutrition: 82 Bills. In 2018, many states addressed childhood nutrition through the state education system. Some states used the National School Lunch Program by matching federal dollars with state dollars, streamlined and modernized the free and reduced-price lunch enrollment process for eligible students and addressed reporting standards. States also addressed childhood nutrition by setting nutritional standards for food and beverages served during school meals or available through vending machines.


Children’s Mental Health—Services: 66 Bills. In 2018, outside of schools, legislatures enacted laws to address children’s mental health in a wide range of settings that include home and community-based programs, hospitals and psychiatric residential facilities. Some legislatures formed children’s mental health advisory committees that track, study or identify access barriers. States also addressed children’s mental health services by changing mandates or rules regulating private insurance or changing public coverage programs.



Children’s Mental Health—Schools: 59 Bills. The 2018 bills enacted in this category address the prevention, tracking/monitoring and treatment of children’s mental illness in the school setting. Some bills were written specifically to address children’s mental health in schools and others incorporate children’s mental health as a component of school safety, overall health or substance use issues. Access to services in schools is a common theme either through awareness campaigns, adding mental health professionals to school health services or insurance coverage of mental health services in schools.

Visit NCSL’s Maternal and Child Health Database to learn about state efforts addressing maternal and child health populations and stay informed as states enact new legislation in 2019.

Erik Skinner is a policy associate in NCSL's Health Program.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.