H-0978.1          _______________________________________________


                                  HOUSE BILL 1410



State of Washington              52nd Legislature             1991 Regular Session


By Representatives Scott, Brough, Valle, Forner, Cole, Beck, Leonard, Wood, Brekke, Wineberry, Anderson, R. Fisher, Locke, Hine, Ludwig, Holland, Jones, Belcher, Winsley and Sheldon.


Read first time January 29, 1991.  Referred to Committee on Health Care.Creating educational programs to help mothers avoid the use of controlled substances and alcohol during pregnancy.

     AN ACT Relating to the use of controlled substances and alcohol during pregnancy; adding a new chapter to Title 70 RCW; creating a new section; and making an appropriation.




     NEW SECTION.  Sec. 1.      The legislature recognizes that drug addiction as well as the use of controlled substances and alcohol during pregnancy constitutes a medical emergency.  The legislature finds that there is a growing state-wide emergency resulting from the epidemic use of controlled substances and alcohol during and immediately after pregnancy and that the emergency is not confined to any particular economic, regional, racial, ethnic, or other group.  The legislature further finds that exposure to such substances has a tremendous health, emotional, and financial impact on both the children born and their mothers, and also on their communities and the state that must confront the serious, long-term problems that result.  The legislature acknowledges that there are currently no clear methods or strategies that are proven effective for preventing such use.  Therefore, the legislature intends to help pregnant women protect themselves and their resulting infants from substance abuse and its effects by promoting the establishment of local programs to develop replicable, locally based prevention strategies to forestall exposure and provide the earliest possible intervention and treatment to benefit both the mothers and their resulting infants. These programs shall encourage broad based local solutions for education, prevention, and provision of opportunities for immediate treatment so that women who seek help are welcomed rather than ostracized.


     NEW SECTION.  Sec. 2.      The secretary of health shall develop and promote state-wide public health prevention and education strategies designed to prevent and address the problems that arise from the use of controlled substances and alcohol during and immediately after pregnancy, and shall promote the development of prevention and education programs at the local level.  These efforts shall be conducted through the division of health promotion and chronic disease prevention.  The secretary shall coordinate state resources with local resources and monitor local pilot projects designed to develop and implement prevention, education, and treatment strategies related to the use of controlled substances and alcohol during and immediately after pregnancy.  The secretary shall coordinate its efforts with other state agencies and programs concurrent with drug and alcohol prevention, education, or treatment.  The secretary may adopt rules to implement this chapter.


     NEW SECTION.  Sec. 3.      The secretary shall promote the development of local prevention and treatment programs, using existing pilot program and community mobilization structures to the extent possible.  The secretary shall fund and provide technical assistance to each pilot project for a maximum of two years, beginning September 1, 1991, and terminating September 1, 1993.  The secretary shall serve as the coordinator and resource bank to the local programs, including coordinating with other state agencies, federal agencies and programs, and other local programs.  The secretary shall, at a minimum:

     (1) Establish four pilot projects based upon applications from local health departments or other local health organizations, or a combination of such groups;

     (2) Provide fifty percent funding support for the local pilot projects up to a maximum of twenty thousand dollars per year for the duration of the pilot project program;

     (3) Assist the local pilot project directly by providing on-site technical assistance including:

     (a) Assisting with the establishment and organization of an advisory committee/community action group;

     (b) Providing various models and options for local prevention and intervention strategies;

     (c) Coordinating the efforts of the pilot projects with each other;

     (d) Coordinating the pilot projects with other state and federal programs and resources;

     (e) Conducting regular meetings among the directors of the local pilot projects;

     (f) Holding annual state-wide meetings or conferences on the subject of local and state strategies for preventing substance abuse during pregnancy;

     (g) Providing limited funding or copying for the development and duplication of written materials or resources, up to a maximum of two thousand five hundred dollars per project per year; and

     (h) Assisting with development of local or state-wide public service announcements or advertising.

     The secretary shall develop and use evaluation mechanisms for the local programs.  The secretary shall perform at least two evaluations on each pilot project each project year and shall share such results with the local project directors.  The secretary shall also monitor and evaluate local and state-wide intervention and treatment strategies that are not part of the prevention and education pilot projects.  The secretary's evaluation, policy, and program planning efforts shall be coordinated with the school of public policy at a four year state university located west of the Cascade mountains.


     NEW SECTION.  Sec. 4.      (1) Local pilot project applications must be submitted by a local health department, health district, or local health organization such as a local health professional organization, hospital, or combination of such groups, that have as a goal the promotion of the public health.  The applications shall include:

     (a) That the applicant shall provide at least fifty percent of the funding for the pilot project, either directly or through other outside grant sources, including private foundations or federal government grant programs but not including funds from this pilot program or other state funds;

     (b) That the applicant shall designate one person as the project director who shall devote a minimum of fifty percent of his or her time to project activities;

     (c) That the applicant is responsible to the secretary for fulfilling the pilot project duties;

     (d) The applicant shall include on an active advisory committee or through written cooperation agreements a range of community organizations and interests, including but not limited to, representatives of local education, local law enforcement agencies, the local courts, drug and alcohol treatment agencies or professionals, and the print, audio, and visual media;

     (e) That the primary goal of the applicant is to develop a community prevention and education strategy based on local resources;

     (f) That the applicant shall develop an initial prevention strategy, using available information from local and state levels and any other available source, and shall revise and refine the strategy during the course of the project;

     (g) That the applicant shall report its progress to the secretary on a quarterly basis, including revisions to the prevention and education strategy and proposals for new efforts at both the local and state levels;

     (h) That the applicant shall participate in state-wide activities designed to develop local and state-wide prevention and education strategies;

     (i) That the applicant will provide assistance to other pilot projects by sharing information and strategies;

     (j) That the applicant will participate in evaluating the success of their efforts;

     (k) That the applicant will provide specific data on their projects as requested by the secretary;

     (l) That the applicant will make final reports to the secretary by September 1, 1993, including a description of the operation of the projects and of the prevention strategies used and deemed successful;

     (m) That the applicant shall make an interim report to the secretary on or before September 1, 1992.  The applicant's reports may discuss how the prevention strategies relate to intervention and treatment programs at the local and state levels, and make recommendations for changes or creation of intervention or treatment strategies which complement the prevention strategies.


     NEW SECTION.  Sec. 5.      No later than October 1, 1993, the secretary shall report to the governor and the standing health committees of the legislature on the results of the pilot programs, including the proposed comprehensive state strategy based on locally operated programs, and their appropriate relationship.  The final report shall also include the current understanding of effective intervention and treatment strategies at the state and local levels, and the appropriate roles of state and local efforts, including the need for additional legislation and proposed public policy changes, if any.  An interim report shall be made to the governor and the standing health committees of the legislature no later than September 15, 1992.


     NEW SECTION.  Sec. 6.      The secretary shall coordinate the pilot project efforts with other drug and alcohol and maternal and infant health programs, including but not limited to programs related to continuum of treatment, early intervention, community mobilization, and the first steps program, and treatment programs at the division of alcohol and substance abuse.


     NEW SECTION.  Sec. 7.      As part of the state and local effort to develop local strategies for preventing substance abuse during pregnancy, both the secretary and each applicant shall monitor the circumstances under which pregnant women who seek treatment for substance abuse are prevented from receiving the desired treatment and try to determine what mechanisms, if any, are needed to assure that treatment is available without delay to those who seek it.  The applicants shall include in their reports to the secretary their findings on the need for such expedited treatment mechanisms, and shall make recommendations as to any appropriate long-term mechanism for ensuring that those who need treatment can obtain it immediately.


     NEW SECTION.  Sec. 8.      The sum of one hundred fifty thousand dollars, or as much thereof as may be necessary, is appropriated for the biennium ending June 30, 1993, from the general fund to the department of health for the purposes of this act.


     NEW SECTION.  Sec. 9.      Sections 2 through 6 of this act shall constitute a new chapter in Title 70 RCW.