Thank you for your inquiry. The measure logic focuses on the babies chart due to the fact that pediatricians and primary care physicians may present the best opportunity for screening mothers due to the frequency of visits during the earlier years of a child’s life.[i] Office interventions take little time to conduct and are effective in detecting those mothers in need of further help, thus making them feasible to conduct in every well-child visit encounter.[ii],[iii] One study found that when pediatricians discussed depression with mothers after a written standardized screen, more women were referred for additional help. Pediatricians can discuss with parents the importance of a support system, the importance of taking time away from the baby, the common feeling of being upset, and the importance of never yelling, hitting, or shaking the baby.[v] Moreover, pediatricians are in an advantageous position to screen mothers as they have more direct interaction than the mother’s regular caregiver. In the postpartum women are more likely to bring their child to checkups than they are to revisit their gynecologist/obstetrician or their primary care provider. This measure aligns with an AAP recommendation. The AAP may be able to provide some guidance about privacy when screening mothers for postpartum depression. Please see the links below for more information. http://pediatrics.aappublications.org/content/early/2010/10/25/peds.2010-2348.full.pdf+html http://www2.aap.org/sections/dbpeds/pdf/Screening%20for%20Maternal%20Perinatal%20Depression.pdf http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Managing-Maternal-Depression-Before-and-After-Birth.aspx [i] VanLandeghem, Karen, MPH. National Academy for State Health Policy. Financing Strategies for Medicaid Reimbursement of Maternal Depression Screening by Pediatric Providers. April 2006. [ii] Olson,AL, et al. Brief Maternal Depression Screening at Well-Child Visits. Pediatrics Volume 118, Number 1, July 2006 [iii] Ibid. [iv] Ibid. [v] Hagan, JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove, IL: American Academy of Pediatrics. [vi] Feinberg., E., Sc.D., C.P.N.P., et al. Report from the CDC. Improving Women’s Health during Internatal Periods: Developing an Evidenced-Based Approach to Addressing Maternal Depression in Pediatric Settings. Journal of Women’s Health. Vl15, No. 6, 2006

currently the measure specification only includes the babies chart, while the guidance mentions both the mother and baby's chart. I would argue it's more clinically relevant to document the mother's maternal depression status in the mother's chart instead of the childs…. especially as that child ages. i would ask you to expand the logic to include the mom's chart.