HOUSE BILL REPORT

                      HB 2364

                     As Reported By House Committee on:

                               Human Services

Title:  An act relating to family planning services for substance abusers.

Brief Description:  Family planning services for substance abusers.

Sponsor(s):  Representatives H. Sommers, Franklin, Moyer, Leonard, Prentice, Morris, Brough, Rust, Miller, Braddock, Dellwo, Winsley, Spanel, Mitchell, Rayburn, R. Johnson, Cooper, Locke, Paris, G. Cole, J. Kohl, Ludwig, Brekke, Ogden, Haugen, Valle and Anderson.

Brief History:

   Reported by House Committee on:

Human Services, January 27, 1992, DPS.

HOUSE COMMITTEE ON

HUMAN SERVICES

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass.  Signed by 7 members:  Representatives Leonard, Chair; Riley, Vice Chair; Winsley, Ranking Minority Member; Anderson; Brekke; R. King; and H. Myers.

Minority Report: Do not pass.  Signed by 2 members:  Representatives Tate, Assistant Ranking Minority Member; and Beck.

Staff:  Bonnie Austin (786-7107).

Background:

Approximately 10 percent of the babies born each year in the United States are affected by prenatal alcohol or drug abuse.  Some of these babies are severely impacted.  Fetal Alcohol Syndrome (FAS) is the primary preventable cause of mental retardation in the United States.  Prenatal cocaine and heroin addiction also have devastating impacts on the developing fetus.

Of the approximately 70,000 babies born every year in Washington, approximately 7,000 are affected by alcohol or drug abuse and a smaller number are severely impacted.  The Department of Health statistics for 1989 are illustrative.  Of the 76,654 babies born in Washington in 1989, 681 were diagnosed at birth as being drug dependent or having FAS.  According to the department, these statistics are artificially low, because FAS is rarely detectable at birth and alcohol and drug related conditions are grossly under reported.

The economic cost of caring for severely impacted babies is staggering.  Initial hospital costs range as high as $24,000 - $30,000 per baby, as opposed to the less than $1,000 average cost for a healthy baby.  The cost of caring for severely premature drug addicted babies can run into hundreds of thousands of dollars.  Additionally, these children may require years of medical treatment, as well as special education.

It has been argued that the most humane and cost-effective way to address this tragedy is to prevent pregnancy until substance abusers are free of their addictions.  One way to approach prevention is to provide family planning services to substance abusers in treatment.

The Department of Social and Health Services is responsible for setting standards for drug and alcohol treatment programs and for organizing training programs for substance abuse counselors.  The Department of Health is responsible for licensing drug and alcohol treatment establishments, as well as contracting for local family planning services.

Summary of Substitute Bill:

The Department of Social and Health Services and the Department of Health, in consultation with representatives from chemical dependency treatment programs and family planning agencies, are required to jointly develop a curriculum and training format for substance abuse counselors.  The curriculum must include information on the risks posed to a fetus from exposure to alcohol or drugs, a review of available birth control methods, and family planning clinic referral information.

Substance abuse counselors employed at state-approved chemical dependency treatment programs are required to receive training on this curriculum after January 1, 1993.  After receiving training, substance abuse counselors are required to discuss prenatal drug impacts and family planning issues with their clients.  The Department of Health is required to track referrals made to family planning services from programs utilizing the curriculum.

Substitute Bill Compared to Original Bill:  Language is added requiring substance abuse counselors to discuss prenatal drug impacts and family planning issues with all of their clients.  The appropriation of $50,000 is deleted.

Fiscal Note:  Requested 1/24/92.

Appropriation:  Removed.

Effective Date of Substitute Bill:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  Babies born addicted to drugs or alcohol suffer agonizing and lifelong debilitations.  These tragedies are completely preventable.  Substance abusers should be encouraged to avoid pregnancy until they are free of their addictions.  Providing family planning information to substance abusers in treatment is a good place to start.

Testimony Against:  None.

Witnesses:  Lis Gildemeister, Washington State Nurses Association; Ken Stark and Bonnie Jacques, Department of Social and Health Services; Lonnie Johns-Brown, Child/Mom Partnership; Laurie Lippold, Children's Home Society; Rose Stidham, Metropolitan Development Council; Yvonne Spies, Planned Parenthood Affiliates of Washington; and Marilyn Knight, Planned Parenthood of Seattle.