H-1701

AN ACT Relating to identifying and providing services to infants and toddlers with special health care needs; adding new sections to chapter 43.70 RCW; making an appropriation; providing an effective date; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. (1) The legislature recognizes that the long-term health, well-being, and development of infants and children is jeopardized by biological and environmental risk factors, including prenatal drug or alcohol exposure. The legislature further finds that medical assessment and tracking of infants and toddlers with special health care needs can reduce long-term adverse medical, social, developmental, and economic consequences when such identification results in the provision of necessary medical, health, and other support services to the child, his or her mother, and family. The legislature further finds that coordination of existing state, federally, and privately funded services to meet the needs of infants and toddlers with special health care needs and their families is essential to promote the long-term health and well-being of such infants and toddlers.

(2) It is the purpose of sections 2 through 7 of this act to provide for state-wide implementation of the high priority infant tracking program, to maximize the use of federally funded programs to meet the needs of infants and toddlers with special health care needs, and to develop protocols relating to assessment and identification of infants affected by maternal alcohol or drug use.

NEW SECTION. Sec. 2. As used in sections 1 through 7 of this act, the following terms have the following meanings, unless expressly provided otherwise:

(1) "Department" means the department of health.

(2) "Drug" means a controlled substance as defined in chapter 69.50 RCW when used for nonmedical purposes.

(3) "Drug test" means the procedure of taking and analyzing body fluids or other materials from the body for the purpose of detecting the presence of a drug, metabolite, or other related substances in the sample tested.

(4) "Health care facility" means a hospital licensed pursuant to chapter 70.41 RCW and birthing centers licensed pursuant to chapter 18.46 RCW.

(5) "Infants and toddlers with special needs" means children from birth through age three who have an increased likelihood of experiencing a disability or developmental delay due to biological risk factors, such as a history of prenatal, perinatal, or neonatal insult, or environmental risk factors, such as a history of drug abuse by parents, family violence, or developmentally disabled or mentally ill parents.

(6) "Medical assessment" means procedures established pursuant to section 4 of this act and performed by a health care professional to screen newborn infants for the purpose of identifying infants with special health care needs.

NEW SECTION. Sec. 3. (1) The high priority infant tracking program is established in the department. The program shall have the goals of:

(a) Identifying all infants in Washington state with or at risk for health and developmental problems; and

(b) Preventing or minimizing the impact of disabilities by tracking the health and developmental status of, and use of community services by, infants and toddlers with special health care needs at predetermined intervals, and by offering parents of such children information and support necessary to link families with health, education, or social services.

(2) Participation in the program by parents of infants and toddlers who have been identified as having special health care needs shall be voluntary.

(3) To the greatest extent practicable, the department shall finance program services through the medicaid program, as provided in chapter 74.09 RCW, and other federally funded programs to maximize federal financing for services provided through the program.

NEW SECTION. Sec. 4. (1) On or before January 1, 1992, the department shall develop standards for newborn assessment in consultation with the University of Washington health sciences division and health professional associations, including physicians, nurses, hospitals, and other appropriate providers.

(2) The standards shall be consistent with the definition of infants and toddlers with special health care needs in section 2 of this act, and shall include medical assessment factors for identifying the presence or effect of alcohol or drugs acquired through exposure from the mother.

NEW SECTION. Sec. 5. (1) Positive results from any drug test shall be deemed confidential and may not be released to law enforcement agencies. Chapter 26.44 RCW shall govern reporting of positive test results to the department of social and health services child protective services program.

(2) When a drug test is ordered, clear documentation of the medical basis for the test shall appear in the medical record of the infant. The rationale, as well as the result of the test, shall be discussed with the mother by the health care professional responsible for the infant's medical care.

NEW SECTION. Sec. 6. The department shall, in consultation with the department of social and health services and individuals with expertise in the effects of biological or environmental risk factors on infants, identify a continuum of services for referral and appropriate intervention to support healthy development of such infants.

(1) The continuum shall incorporate the following programs:

(a) High priority infant tracking program, as provided in section 3 of this act;

(b) First steps maternity care access program, as provided in chapter 74.09 RCW;

(d) Early periodic screening, diagnosis, and treatment component of the medical assistance program; and

(e) Other existing state, federally, or privately funded programs providing services to infants and toddlers with special health care needs.

(2) To the extent feasible, services shall be offered jointly to the family and infant in a manner that promotes and preserves positive bonding of the family and infant.

NEW SECTION. Sec. 7. Each disciplinary authority under chapter 18.130 RCW whose licensees provide prenatal, obstetrical, or pediatric services shall prepare and distribute appropriate educational materials to such licensees on the effects of alcohol and drug use during pregnancy. The materials shall include information on identifying signs of maternal alcohol or drug use, the effects of prenatal alcohol or drug exposure on infants, medical assessment protocols developed pursuant to section 4 of this act, and referral of affected infants and their mothers to appropriate treatment and services. The education and training materials shall be prepared in consultation with the department of social and health services and the department.

NEW SECTION. Sec. 8. The sum of five million five hundred 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 state-wide implementation of the high priority infant tracking program established pursuant to section 3 of this act.

NEW SECTION. Sec. 9. Sections 1 through 7 of this act are each added to chapter 43.70 RCW.

NEW SECTION. Sec. 10. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect July 1, 1991.