A Bucks County lawmaker has introduced legislation that would close a loophole in state law that allows some newborns with prenatal drug exposure to fall under the radar of county child protection authorities, violating a 2003 federal law.
Rep. Katharine Watson, R-144, of Warrington, on Friday introduced a bill that would reverse a 2015 amendment to the state’s Child Protective Services Act that created exempted health care providers from reporting infants born exposed to drugs when mothers were legally prescribed addictive narcotics during pregnancy.
“For the sake of the adult, for the sake of that child, I think we need to check on them,” said Watson, who also chairs the House Child and Youth Committee. “At the very best, if you are by yourself, recovery is tough, and add in the responsibility of another human life with it, and I cannot imagine.”
The legislation was introduced weeks after this news organization exposed the dramatic gap between the number of drug-exposed newborns reported under Medicaid and the number of child welfare reports for prenatal drug exposure. The story was part of our ongoing “Born into Addiction” series, which examines the impact of the drug epidemic, led by opioid and opiate addiction, on the lives of children.
Watson, who credited the series with inspiring the legislation, cited data from the series in her co-sponsorship memo.
Our findings — which Watson called “startling" — included data showing that just under 2,100 Pennsylvania newborns whose deliveries were funded by Medicaid health insurance were diagnosed with narcotics withdrawal syndrome. But, only 972 newborns were referred to county child welfare authorities for assessment.
In 2015, the first year the state broke out data for substance-exposed newborns, 707 infants born to mothers on Medicaid were reported to child welfare as being exposed to narcotics, but 2,350 babies were diagnosed with withdrawal from narcotics, according to the statistics from the state Department of Human Services.
None of those numbers include exposed newborns born to mothers with private health insurance because no agencies collect that data.
The gap shouldn't exist under the federal Child Abuse Protection and Treatment Act, known as CAPTA. It requires health care providers to advise child welfare authorities of all prenatal exposure to narcotics or alcohol or infants that show signs of withdrawal. Those authorities are required to assess the infant’s home environment and develop a safe-care plan, which may include services to drug-dependent parents, before a newborn is sent home.
Congress updated the federal law again in 2016 to clarify that health care providers must refer all cases of drug-exposed infants to child welfare agencies, regardless of whether the exposure was to legal or illegal drugs. But the Pennsylvania Department of Human Services has long interpreted the federal mandate to apply only to babies whose mothers took illegal or unprescribed drugs or misused prescription drugs during pregnancy. Its interpretation was made law when it was added to an update of the state’s child protection law in 2015.
As a result, Pennsylvania health care providers involved in the delivery or care of substance-exposed newborn aren't required to report the birth to child protection — and child protection officials aren't obligated to get assess them if the mothers were legally prescribed narcotics, such as oxycodone or methadone.
Medication Assisted Therapy uses opiate replacement drugs as part of drug treatment of pregnant women dependent on synthetic opiods or opiates like heroin. The therapy exposes developing babies to the drugs, which increases their risk of experiencing narcotic withdrawal symptoms soon after birth.
The Pennsylvania Department of Human Services has created a task force to develop recommendations for lawmakers to amend the state law to bring it into compliance with the federal law. It failed to meet a June 30 federal deadline to submit a plan, but received an extension.
“Our state’s laws should not allow the sending of any substance-exposed newborns — or any newborn, for that matter — home with mothers who by virtue of their substance abuse disorder are unable to properly care for the infant or who may put the infant in serious danger,” Watson said.
She emphasized the change shouldn't be seen as punitive against women who enter drug treatment during pregnancy or women in long-term recovery. Watson said she believes her bill strikes a balance between protecting vulnerable newborns and encouraging pregnant women to enter or continue drug treatment.
Child advocate Cathleen Palm agreed the challenge for advocates and lawmakers is finding balance between recognizing the needs of these newborns and parents who may be struggling with addiction. Palm is the founder and director of the Center for Children’s Justice in Berks County.
“I would encourage people to look beyond what we have always done, which is divide ourselves into the 'camp for mom' or the 'camp for the baby,' ” Palm said. “I think we all have to be in the camp for the mom and the baby together.”
Palm said she suspects the bill will give lawmakers the opportunity to talk about issues related to funding for treatment for pregnant and parenting women and related issues such as safe housing and child care, which are the two biggest barriers that prevent women from entering drug treatment.
Rep. Gene DiGirolamo, R-18, of Bensalem, who chairs the House Human Services Committee, and Rep. John Galloway, D-140, of Falls, on Monday said they support Watson’s bill and plan to sign on as cosponsors. Reps. Todd Stephens, R-151, of Horsham, Thomas Murt, R-152, of Upper Moreland, and Bernie O’Neill, R-29, of Warminster are already cosponsors.
“Of course, I'm concerned,” Rep. Scott Petri, R-178, of New Hope, wrote in an email expressing support for the bill. “You would have to be heartless to not want to help newborn children who have become addicted through no fault of their own.”
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