S-2250.1  _______________________________________________

 

                    SUBSTITUTE SENATE BILL 5278

          _______________________________________________

 

State of Washington      55th Legislature     1997 Regular Session

 

By Senate Committee on Human Services & Corrections (originally sponsored by Senators Patterson, Hargrove, Winsley, Wood, Benton, Goings, Prince, Bauer, Sheldon, Heavey, Long, Anderson, Haugen and Oke)

 

Read first time 03/05/97.

Establishing procedures regarding mothers giving birth to drug-affected infants.


    AN ACT Relating to involuntary use of long-term pharmaceutical birth control for mothers who have given birth to a child with drug addiction; adding new sections to chapter 13.34 RCW; adding new sections to chapter 70.96A RCW; creating new sections; and providing an effective date.

 

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

 

    NEW SECTION.  Sec. 1.  The legislature finds that all children have the right to be born healthy and free of the consequences of the nonprescription use of controlled substances by the mother during pregnancy.  Individuals who have a drug addiction are unable to make reasoned decisions that help ensure the birth of a healthy infant.  The availability of long-term pharmaceutical birth control, when combined with other treatment regimens, may allow women to regain control of their lives and make long-term decisions in the best interest of themselves and their children.  The legislature further finds that a third or subsequent drug-affected infant being born to the same mother means it is unreasonable to attempt to continue efforts to reunify the family and that all reasonable reunification efforts that have previously been made have proven futile and there is no likelihood that future efforts will produce a different outcome.

 

    NEW SECTION.  Sec. 2.  A new section is added to chapter 13.34 RCW to read as follows:

    (1) A physician licensed under chapter 18.71 RCW primarily responsible for the supervision of the birth of an infant, or a hospital administrator, who has reasonable cause to believe an infant has been exposed to nonprescription use of controlled substances shall:  (a) Conduct appropriate tests to determine whether the infant is drug-affected; (b) notify the department of the name and address of the parents of an infant who is drug-affected; and (c) retain the infant in the birthing facility for medical treatment or place the infant in an appropriate pediatric care facility with the concurrence of the department for sufficient time for the infant to undergo withdrawal from the affects of the controlled substances.  The withdrawal shall be under the supervision of appropriate medical professionals.

    (2) The physician shall, as soon as practical, inform the mother of a drug-affected infant of:  (a) Her right to publicly funded tubal ligation surgery as provided under section 13 of this act; (b) available drug treatment and counseling; and (c) birth control counseling and education.  The mother may accept the offer of a tubal ligation up to six months following its tender.

 

    NEW SECTION.  Sec. 3.  A new section is added to chapter 13.34 RCW to read as follows:

    (1) The department, upon receipt of a report under section 2 of this act, shall investigate and, in appropriate cases, file a dependency petition.  In the event the department does not file a petition, it shall refer the mother to available chemical dependency treatment programs or a pilot project.

    (2) The department and the mother may enter an agreement in which the mother agrees to chemical dependency treatment on an inpatient or outpatient basis or be referred to a pilot project created under section 10 of this act.

    (3) If the department and mother enter an agreement under subsection (2) of this section, the department shall, if a dependency petition has been filed, request the court to defer the entry of an order of dependency for as long as the mother remains in treatment or enrolled in the pilot project, subject to the department's monitoring for compliance.  As a condition of deferral of the order of dependency, the parents, if both are available and known, shall stipulate to facts sufficient to constitute a dependency and the court shall order treatment or enrollment in a pilot project and prohibit nonprescription use of controlled substances.  In the event that an available parent unreasonably refuses to stipulate to facts constituting a dependency, the court may proceed with the hearing on the petition.

 

    NEW SECTION.  Sec. 4.  A new section is added to chapter 13.34 RCW to read as follows:

    (1) If the department receives a report under section 2 of this act of a mother who has given birth to a second drug-affected infant, the department:

    (a) May request the court to proceed immediately with the entry of a dependency for the first drug-affected infant; and

    (b) Shall investigate and, unless there are compelling reasons to the contrary, file a dependency petition on the second drug-affected infant.  If the department does not file a petition, it shall refer the woman to available chemical dependency treatment programs or a pilot project.

    (2) The department and the mother may enter an agreement in which the mother agrees to:  (a) Enter chemical dependency inpatient treatment or a pilot project, together with an aftercare program that includes participation in a pilot project when feasible; and (b) medically appropriate pharmaceutical pregnancy prevention, such as Norplant or depo-provera, that is administered not less than once every thirty days.  The selection of the pregnancy prevention method shall be based on an evaluation of the medical and physical consequences to the mother and shall remain in effect until the dependency petition is dismissed or the court determines it is no longer medically appropriate.

    (3) If the department and the mother enter an agreement under subsection (2) of this section, the department shall request the court to defer the entry of an order of dependency on the second drug-affected infant for as long as the mother remains in treatment or enrolled in the pilot project, subject to the department's monitoring for compliance.  As a condition of deferral of the order of dependency, the parents, if both are available and known, shall stipulate to facts sufficient to constitute a dependency and the court shall order treatment or enrollment in a pilot project and prohibit nonprescription use of controlled substances.  In the event that an available parent unreasonably refuses to stipulate to facts constituting a dependency, the court may proceed with the hearing on the petition.

 

    NEW SECTION.  Sec. 5.  A new section is added to chapter 13.34 RCW to read as follows:

    The department may request the court to dismiss the petition deferred under section 3 or 4 of this act at any time, but a petition may not be vacated or dismissed unless the mother demonstrates by clear and convincing evidence that she has not used controlled substances in a nonprescription manner for at least thirty-six consecutive months and can safely provide for the child's welfare without continuing supervision by the department or court.

 

    NEW SECTION.  Sec. 6.  A new section is added to chapter 13.34 RCW to read as follows:

    If the department receives a report under section 2 of this act of a mother who has given birth to a third or subsequent drug-affected infant, the department shall:

    (1) Request the court to proceed immediately with the entry of a finding of dependency on all drug-affected children born before the third or subsequent birth unless an order of dependency has been vacated or dismissed; and

    (2) File a dependency petition on any drug-affected infant subject to this section as well as any other child born before the third or subsequent birth of a drug-affected infant.

 

    NEW SECTION.  Sec. 7.  A new section is added to chapter 13.34 RCW to read as follows:

    Following a filing of a petition under section 6 of this act:

    (1) The court shall order medically appropriate pharmaceutical pregnancy prevention, such as Norplant or depo-provera, that is administered not less than once every thirty days.  The selection of the pregnancy prevention method shall be based on an evaluation of the medical and physical consequences to the mother and shall remain in effect until the petition is dismissed or the court determines it is no longer medically appropriate.

    (2) If the court has ordered removal of a child or children, the out-of-home placement order shall remain in effect until the petition is dismissed or the mother has successfully completed inpatient treatment and any aftercare program for controlled substances ordered by the court.

 

    NEW SECTION.  Sec. 8.  A new section is added to chapter 13.34 RCW to read as follows:

    There is a rebuttable presumption in any petition filed under section 6 of this act that termination of parental rights is in the best interest of the child and it is unreasonable to provide services to reunify the children with the mother.

 

    NEW SECTION.  Sec. 9.  By July 1, 1998, the department of social and health services, in consultation with the department of health, shall adopt rules to implement this act, including a definition of "drug-affected infant," which shall be limited to infants who are affected by a mother's nonprescription use of controlled substances.

 

    NEW SECTION.  Sec. 10.  The department shall operate a pilot project to provide services to women who give birth to infants exposed to the nonprescription use of controlled substances by the mother during pregnancy.  The project shall be offered in one site in each of the department's administrative regions.  The project shall accept women referred to it by the department following the birth of a drug-affected infant.  The pilot project shall be concluded by July 1, 2002.

 

    NEW SECTION.  Sec. 11.  The institute for public policy shall study the effectiveness of the pilot project created under section 10 of this act and report to the governor and legislature not later than September 1, 2001.  The study shall measure the reduction in the birth rate of drug-affected infants among women referred to the pilot project and shall compare the reduction with the rate of birth of drug-affected infants born to women referred to chemical dependency treatment programs.  The study shall identify the factors that promote or discourage the ability of women referred to the pilot project to avoid giving birth to drug-affected infants.

 

    NEW SECTION.  Sec. 12.  A new section is added to chapter 70.96A RCW to read as follows:

    Any treatment program or pilot project in which a mother is enrolled under sections 3 through 5 of this act shall provide family planning, education, counseling, information, and services other than pregnancy termination.

 

    NEW SECTION.  Sec. 13.  A new section is added to chapter 70.96A RCW to read as follows:

    The department shall make available, or cause to be made available, pharmaceutical birth control services, information, and counseling to any person who enters chemical dependency treatment under section 3 or 4 of this act.  The department shall pay for any tubal ligations requested under section 2 of this act if the mother's income is less than two hundred percent of the federal poverty level.  The department shall report by December 1st of each year to the governor and legislature:  (1) The number of tubal ligations performed as a result of chapter . . ., Laws of 1997 (this act); (2) the number of women who decline to undergo the surgery; (3) the number of women who obtain pharmaceutical birth control, by type of birth control; and (4) the number of women who are reported to the department.

 

    NEW SECTION.  Sec. 14.  The department of social and health services shall study the costs and benefits associated with including mothers of children born affected by alcohol or with fetal alcohol syndrome in the services and responsibilities established in this act.  The study shall include a review of appropriate medical and social science research.  The department shall report to the governor and legislature by December 1, 1997.

 

    NEW SECTION.  Sec. 15.  Sections 1 through 8 and 10 through 13 of this act take effect July 1, 1998.

 


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