Pennsylvania lawmakers are moving closer to fixing a loophole in state law that would ensure newborns with prenatal narcotics exposure are put on the child protection radar regardless of the type of drug their mothers used.
Yet some child advocates are concerned health care providers and child protection authorities would be left more confused over how to handle referrals if the law is enacted without written guidelines in place.
At least 525 newborns have been diagnosed with signs of narcotics withdrawal during the first 13 weeks after Gov. Wolf declared a state of emergency in response to the opioid and opiate crisis on Jan. 10, according to health officials. That works out to just under six births a day.
Pennsylvania is out of compliance with the federal Child Abuse Protection and Treatment Act, known as CAPTA, which requires states to develop policies to refer newborns prenatally exposed to narcotics or alcohol or who show signs of drug or alcohol withdrawal to child protection and develop plans to keep the babies safe before they are discharged.
Pennsylvania law specifically exempts from those referrals drug-exposed children up to age 1 who are born to mothers who took narcotics as directed under medical supervision, including heroin replacement drugs such as methadone, which is commonly prescribed for heroin use during pregnancy as part of drug treatment, but can still result in Neonatal Abstinence Syndrome, or NAS, a collection of symptoms closely related with opiate and opioid withdrawal. The federal government has given the state until June 30 to comply with CAPTA or risk losing $1 million a year in federal child welfare funding.
State lawmakers took a big step toward meeting the federal deadline last week when, during a Senate Youth and Aging Committee hearing, an amendment was added to a House bill sponsored by Montgomery County Rep. Thomas Murt, R-152, of Hatboro, that would require all schools in the state prominently display a poster containing statewide hotline number for reporting suspected child abuse.
Committee Chairwoman Sen. Michelle Brooks, R-50, introduced the amendment — which would take effect immediately if the law is signed — that was submitted by the state Department of Human Services. The bill was subsequently unanimously approved on Tuesday and now heads back to the House Child and Youth Committee for consideration.
The amendment would require health care workers report Pennsylvania children under age 1 identified as being affected by prenatal substance use or withdrawal symptoms and specify that the notification is “not deemed child abuse.”
The proposed change removes county child welfare agencies as the agency responsible for conducting the immediate safety and risk assessments and developing a safe care plan, but it doesn’t identify what entity will take over those duties or whom health care workers would contact to refer suspected drug exposed babies.
That is because those details have yet to be worked out.
The Departments of Health and Drug and Alcohol Programs, the entities responsible for creating the protocols for implementation of a plan of safe care under the amendment, still are writing those guidelines, according a DHS spokeswoman. DHS will identify a “lead entity” responsible for developing plans of safe care for children, and convening a multi-disciplinary team with an unidentified purpose, according to the amendment.
DHS Press Secretary Rachel Kostelac said state officials are continuing discussions with the Work Group for Infant with Substance Exposure, which has been meeting for nearly two years, to finalize recommendations for safe care plan protocols. She added that interim guidance would be issued, should the law be passed before the full protocol is ready. As of Friday, those guidelines are not yet in final draft form, she added.
The lack of interim guidelines has some child welfare advocates concerned.
The state protocols will be critical to effective community response for the infant, parents and their family, said Lynne Kallus-Rainey, director of Bucks County Children and Youth.
Cathleen Palm, founder and executive director for Children’s Justice in Berks County, who sits on the state work group, is among those worried that finalizing the protocols could take up to six months, but lawmakers will feel the pressure to hurry up and pass a bill to meet the June 30 deadline.
“If you can’t, on the same day this becomes a law, have a specific set of well-understood protocols and practices then we could be unintentionally creating loopholes where infants fall off the radar,” Palm said.
The delay in introducing legislation to bring the state into CAPTA compliance has centered on drafting a law that protects the drug-affected children but does not unintentionally punish the mother with a substance abuse disorder, a move that many child advocates believe discourages pregnant drug users from seeking or continuing drug treatment and prenatal care, Palm said.
Palm applauded the proposed amendment for specifying that referrals should not be deemed as child abuse as “quite significant and extremely instructive.”
“The language underscores that we want women to feel at ease honestly discussing their use of drugs so that they can receive treatment they need,” Palm added. “They can be prepared, as well as health care staff, for any side effects the baby might develop based on the exposure.”
Palm believes the proposed legislation gives Pennsylvania an opportunity to advance the public health approach to treating pregnant and parenting drug users, but it will require “hard, hard work.”
“We have to get real about what we mean and how we define a plan of safe care, how we triage the infant and family, and how it is determined who is the lead agency responsible for providing services, checking up on the safety and well-being of the infant and his or her family,” Palm said. “Overall I think that the legislation reflects we need to recognize not every incident, not every family, is the same. We have to consider their circumstance, that is the positive.”
No comments:
Post a Comment