S-1371

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

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

NEW SECTION. Sec. 1. The legislature recognizes that the use of alcohol and other drugs during pregnancy can cause medical, psychological, and social problems for women and infants. The legislature further recognizes that communities are increasingly concerned about this problem and the associated costs to the mothers, infants, and society as a whole. The legislature recognizes that the department of health and other agencies are focusing on primary prevention activities to reduce the use of alcohol or drugs during pregnancy but few efforts have focused on secondary prevention efforts aimed at intervening in the lives of women already involved in the use of alcohol or other drugs during pregnancy. The legislature recognizes that the best way to prevent problems for chemically dependent pregnant women and their resulting children is to engage the women in alcohol or drug treatment. The legislature acknowledges that treatment professionals find pretreatment services to clients to be important in engaging women in alcohol or drug treatment. Therefore the legislature intends to prevent the detrimental effects of alcohol or other drug use to women and their resulting infants by promoting the establishment of local programs to help facilitate a pregnant woman's entry into alcohol or other drug treatment. These programs shall provide secondary prevention services and provision of opportunities for immediate treatment so that women who seek help are welcomed rather than ostracized.

NEW SECTION. Sec. 2. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

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

(2) "Chemically dependent individual" means someone suffering from alcoholism or drug addiction, or dependence on alcohol or one or more other psychoactive chemicals.

(3) "Alcoholism" means a disease, characterized by a dependency on alcoholic beverages, loss of control over the amount and circumstances of alcohol use, symptoms of tolerance, physiological or psychological withdrawal, or both, if use is reduced or discontinued and impairment of health or disruption of social or economic functioning.

(4) "Approved treatment program" means a discrete program of chemical dependency treatment provided by a treatment program certified by the department of social and health services as meeting standards adopted under this chapter.

(5) "Drug addiction" means a disease characterized by a dependency on psychoactive chemicals, loss of control over the amount and circumstances of use, symptoms of tolerance, physiological or psychological withdrawal, or both, if use is reduced or discontinued, and impairment of health or disruptions of social or economic functioning.

(6) "Treatment" means the broad range of emergency detoxification, residential, and outpatient services and care, including diagnostic evaluation, chemical dependency education and counseling, medical, psychiatric, psychological, and social service care, vocational rehabilitation, and career counseling, that may be extended to chemically dependent individuals and their families.

(7) "Treatment program" means an organization, institution, or corporation, public or private, engaged in the care, treatment, or rehabilitation of chemically dependent individuals.

(8) "Secondary prevention" means identifying and obtaining an assessment on individuals using alcohol or other drugs for referral to treatment when indicated.

(9) "Primary prevention" means providing information about the effects of alcohol or drug use to individuals so they will avoid using these substances.

(10) "Tertiary prevention" means providing treatment to limit the negative impact of alcohol or drug use on an individual's life.

(11) "Assessment" means an interview with an individual to determine if he or she is chemically dependent and in need of referral to an approved treatment program.

(12) "Pretreatment" means the period of time prior to an individual's enrollment in alcohol or drug treatment.

(13) "Pretreatment services" means activities taking place prior to treatment that include identification of individuals using alcohol or drugs, education, assessment of their use, evaluation of need for treatment, referral to an approved treatment program, and advocacy on a client's behalf with social service agencies or others to ensure and coordinate a client's entry into treatment.

(14) "Secretary" means the secretary of the department of social and health services.

NEW SECTION. Sec. 3. The secretary shall develop and promote state-wide secondary prevention strategies designed to increase the use of alcohol and drug treatment services by women of child-bearing age, before, during, and immediately after pregnancy. These efforts are conducted through the division of alcohol and substance abuse. The secretary shall:

(1) Promote development of four pilot demonstration projects in the state to be called pretreatment projects for pregnant women. Two of the pilot projects are in urban areas and two are in rural areas.

(2) Ensure that one of the four projects is located in a public health department clinic providing maternity services and one is located in a county correctional facility.

(3)(a) Hire a certified chemical dependency counselor to work as a substance abuse educator in the public health clinic for a salary of forty-two thousand dollars, and hire a certified chemical dependency counselor to work as a substance abuse educator in a county correctional facility for a salary of forty-two thousand dollars.

(b) Ensure that the duties and activities of the certified chemical dependency counselors include, at a minimum, the following:

(i) Identify substance-using pregnant women in the health clinic or correctional facility;

(ii) Educate the women on the effects of alcohol or drugs on health, pregnancy, and unborn children;

(iii) Determine the extent of the women's substance use;

(iv) Evaluate the women's need for treatment;

(v) Make referrals for chemical dependency treatment if indicated;

(vi) Facilitate the women's entry into treatment; and

(vii) Advocate on the client's behalf with other social service agencies or others to ensure and coordinate clients into treatment.

(4) Promote development of two pilot projects through a request-for-proposal process. The purpose of the request-for-proposal process is to solicit applications to provide pretreatment services to facilitate a chemically dependent pregnant woman's entry into alcohol or drug treatment.

(a) The proposals must address each of the following pretreatment services: Identification of alcohol or drug use, education, assessment of alcohol or drug problems, evaluation, referral, and advocacy with other social service organizations or others to ensure a client's entry into treatment.

(b) Proposals must address how applicant will access target population.

(d) Eligible applicants should have prior experience with alcohol or drug issues.

(5) Administrative costs of the department are limited to ten percent of the funds appropriated for the project.

NEW SECTION. Sec. 4. The sum of four hundred eighty-eight 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 social and health services for the purposes of this act.

NEW SECTION. Sec. 5. Sections 2 and 3 of this act are each added to Title 70 RCW.