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AN ACT Relating to infants exposed to drugs; adding a new chapter to Title 70 RCW; and creating a new section.

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

NEW SECTION. Sec. 1. LEGISLATIVE INTENT. The legislature finds that chemical drug exposure during pregnancy jeopardizes the long-term health and well-being of infants. The legislature declares that adequate medical care during and after pregnancy, chemical abuse treatment for pregnant women, and other support services for the child and mother are needed to minimize the adverse effects of chemical abuse. The legislature has demonstrated its commitment to providing these services through a significant expansion of maternity care and child health services. It has also expanded chemical abuse treatment and support services for pregnant women through the enhancement of inpatient and outpatient services, transitional housing, case management and child care. The legislature further finds that early identification through medical assessment of at-risk, chemically exposed infants can reduce long-term adverse medical, social, and economic consequences only when such identification results in the provision of needed medical and support services. It further declares that well integrated and coordinated delivery of services to mothers and infants is essential to promote the long-term health and well-being of chemically exposed infants.

NEW SECTION. Sec. 2. DEFINITIONS. As used in this chapter, the terms in this section have the meanings indicated unless the context clearly requires otherwise.

(1) "Department" means department of social and health services.

(2) "Drug" means a controlled substance under chapter 69.50 RCW used for nonmedical purposes.

(3) "Health care facility" means a hospital as licensed in chapter 70.41 RCW.

(4) "Medical assessment" means a procedure established in rule by the state board of health and conducted by a health care facility for screening newborn infants to identify those who have been exposed to drugs prior to birth.

(5) "Nonmedical purpose" means use of a controlled substance as defined in chapter 69.50 RCW for purposes other than prescribed by an authorized health care practitioner as defined in RCW 69.50.101.

(6) "Positive case" means a finding by a health care facility that drugs are present in a newborn infant and is based upon a medical assessment.

NEW SECTION. Sec. 3. MEDICAL ASSESSMENT OF AT-RISK INFANTS--CONFIDENTIALITY OF ASSESSMENTS. (1) Prior to discharge, every health care facility shall cause to be conducted a medical assessment of newborn infants delivered at the facility to determine the presence of drugs acquired through exposure from the mother. The medical assessment shall be used to determine the need for immediate and postdischarge medical care, drug treatment, and support services for the mother and child.

(2) The health care facility shall report positive cases to the department so that department-sponsored or funded treatment and support services can be made available to the mother and child. The department and health care facility shall establish reasonable and appropriate time limits by which the facility must make its report to the department.

(3) The identity of positive cases shall be deemed confidential and shall not be released to law enforcement agencies or county or city prosecutors for the purposes of evidence of possession or use of a controlled substance on the part of the mother.

NEW SECTION. Sec. 4. MEDICAL ASSESSMENTS--STATE BOARD OF HEALTH ACTIVITIES. The state board of health, in consultation with medical providers and researchers who have specialized knowledge of the effects of drug exposure on infants, shall establish appropriate standards for conducting medical assessments of newborn infants to determine drug exposure prior to birth. Such standards may be updated from time to time. The standards shall assure accurate, fair, and consistent medical assessments of newborn infants. Every health care facility shall develop and utilize facility standards for use in conducting medical assessments based upon those developed by the state board of health.

NEW SECTION. Sec. 5. DEPARTMENT EVALUATION OF HOME--PLAN OF CARE --MONITORING OF MOTHER AND CHILD. (1) When the department receives a report of a positive case from a health care facility it shall within one week conduct an evaluation of the newborn infant's home to determine whether the health and safety of the child is in imminent danger because of the misuse or suspected misuse of controlled substances by the mother or other household members.

(2) Should the evaluation determine the child is not in imminent danger, the department shall within two weeks of the evaluation prepare a plan of care for the mother and child specifying substance abuse treatment services, child health care services and other support services necessary to assure the health and safety of the child.

(3) The plan shall be prepared with the assistance of the child's physician, or a physician designated by the health care facility if the child has no physician, a representative from the department and a qualified substance abuse counselor or public health nurse with training in substance abuse. The plan shall identify those state‑sponsored services for which the mother and child are eligible. Disagreements over the content of the plan may be appealed by the mother through a hearing as provided for in chapter 34.05 RCW.

(4) The department shall monitor the mother and child for a period of six months to assure that services identified in the plan of care are being received, including the mother's participation in a substance abuse treatment program if such a program is included in the plan. The department shall also monitor the child's home environment to assure that the safety and health of the child is not in imminent danger because of misuse of controlled substances by any household member.

(5) Should the department determine that the services in the plan of care have been refused by the mother, and as a result the health and safety of the child is in imminent danger, it shall pursue its obligation under chapter 26.44 RCW.

(6) The department may extend monitoring activities beyond six months should it determine it is in the best interest of the child to do so. If an extension is granted to the plan of care, an amendment to the plan of care shall be made specifying the reasons for the extension and duration of time for which monitoring shall be extended.

(7) This section shall not restrict or otherwise limit the department from its obligations under chapter 26.44 RCW should it determine the child is subject to child abuse and neglect as defined in RCW 26.44.020.

NEW SECTION. Sec. 6. INTERAGENCY COORDINATION OF SERVICE DELIVERY. The department and the department of health shall assure that the delivery of available services to chemically dependent pregnant women and chemically dependent mothers and infants are coordinated so that (1) all available medical and support services offered through or paid by the agencies are provided, (2) existing community-based services are identified and utilized, (3) to the extent feasible, services be offered jointly to the mother and infant in a manner that promotes and preserves positive bonding of the mother and infant, (4) possible long-term developmental disabilities are identified early to minimize adverse health consequences, and (5) the department and the department of health are able to track clients and the services they receive across programs and agency lines.

NEW SECTION. Sec. 7. EDUCATION FOR HEALTH CARE PROFESSIONALS. Each disciplining authority under chapter 18.130 RCW whose license holders provide prenatal, obstetrical, and pediatric services shall adopt rules and prepare and distribute appropriate educational material to such license holders on the effects of substance abuse by pregnant women. The training and education shall include information on identifying signs of drug usage, the effects of drug exposure, conducting medical assessments as required by this chapter, and referring patients to appropriate treatment and services. The disciplining authorities shall work with the department and the department of health to develop education and training material.

NEW SECTION. Sec. 8. CAPTIONS NOT LAW. Section captions as used in this act constitute no part of the law.

NEW SECTION. Sec. 9. Sections 1 through 7 of this act shall constitute a new chapter in Title 70 RCW.