BILL REQ. #:  H-1083.1 

Read first time 02/17/2005.   Referred to Committee on Health Care.

     AN ACT Relating to the use of pharmaceutical birth control or tubal ligation in cases of children born alcohol or drug-affected; adding new sections to chapter 13.34 RCW; providing an effective date; and declaring an emergency.

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 from the consequences of alcohol abuse or illegal drug use by the mother during pregnancy. Babies who are born alcohol or drug-affected are more likely to suffer from premature birth and low birth weight, to be shorter, weigh less, and have a smaller head size, and to develop health problems than children born to mothers who did not abuse alcohol or use illegal drugs. The legislature further finds that the state has a compelling interest in protecting unborn children from the harmful effects of alcohol abuse and illegal drug use during pregnancy and that requiring pharmaceutical birth control or tubal ligation for women who are incapable for whatever reason of making long-term decisions in controlling their abuse of alcohol or use of illegal drugs is in the best interest of the mothers and their children.

NEW SECTION.  Sec. 2   (1) If a physician, physician assistant, advanced registered nurse practitioner, including a certified nurse midwife, or licensed midwife is consulting, treating, providing care for, or working with a pregnant woman, and the physician, physician assistant, advanced registered nurse practitioner, including a certified nurse midwife, or licensed midwife discovers or reasonably believes that the woman's unborn child is alcohol or drug-affected or is likely to be alcohol or drug-affected, the physician, physician assistant, advanced registered nurse practitioner, including a certified nurse midwife, or licensed midwife shall inform the woman of the provisions of this act and of available alcohol or drug dependency treatment programs and counseling.
     (2) A physician licensed under chapter 18.71 RCW primarily responsible for the supervision of the birth of an infant or care of the mother of the infant, or a hospital administrator, who has reasonable cause to believe an infant is alcohol or drug-affected or has been exposed to alcohol abuse or the use of illegal drugs shall: (a) Conduct appropriate tests to determine whether the infant is alcohol or drug-affected; (b) notify the department of the name and address of the parents of an infant who is alcohol or 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 effects of the alcohol or drug. The withdrawal shall be under the supervision of appropriate medical professionals. In addition, the physician shall, as soon as practical, inform the mother of the alcohol or drug-affected infant of the provisions of this act and of available alcohol or drug dependency treatment programs and counseling.

NEW SECTION.  Sec. 3   (1) The department, upon receipt of a report under section 2 of this act, shall investigate and, in cases where a physician has determined the infant is alcohol or drug-affected, shall file a petition in the superior court requesting the court to issue an order requiring the mother to abstain from alcohol or the nonprescription use of controlled substances, to submit to random testing by the department for such substances, and to attend alcohol or drug dependency treatment programs and counseling as determined appropriate by the department. If the evidence supports the physician's determination that the infant is alcohol or drug-affected and that the infant is alcohol or drug-affected as a result of the ingestion of alcohol or drugs by the mother, the court shall issue the order.
     (2) If a mother previously has been issued an order under subsection (1) of this section and the department receives another report under section 2 of this act, the department shall investigate and, in cases where a physician has determined the infant is alcohol or drug-affected, shall file a petition in the superior court requesting the court to issue an order requiring the mother to abstain from alcohol or the nonprescription use of controlled substances, to submit to random testing by the department for such substances, to attend alcohol or drug dependency treatment programs and counseling as determined appropriate by the department, and to submit to the involuntary use of the pharmaceutical birth control, Norplant or depo-provera, and it shall be administered not less than once every thirty days, unless an evaluation of the medical and physical consequences to the mother determines such use of Norplant or depo-provera would prove harmful to the physical well-being of the mother. The use of Norplant or depo-provera shall remain in effect until a petition is dismissed or the court determines it is no longer medically appropriate. If the evidence supports the physician's determination that the infant is alcohol or drug-affected, that the infant is alcohol or drug-affected as a result of the ingestion of alcohol or drugs by the mother, and that the mother previously has been issued an order under subsection (1) of this section, the court shall issue the order.
     (3) If a mother previously has been issued an order under subsection (2) of this section and the department receives another report under section 2 of this act, the department shall investigate and, in cases where a physician has determined the infant is alcohol or drug-affected, shall file a petition in the superior court requesting the court to issue an order requiring the mother to abstain from alcohol or the nonprescription use of controlled substances, to submit to random testing by the department for such substances, to attend alcohol or drug dependency treatment programs and counseling as determined appropriate by the department, and to submit to the involuntary use of tubal ligation, unless an evaluation of the medical and physical consequences to the mother determines that the tubal ligation would prove harmful to the physical well-being of the mother. If the evidence supports the physician's determination that the infant is alcohol or drug-affected, that the infant is alcohol or drug-affected as a result of the ingestion of alcohol or drugs by the mother, and that the mother previously has been issued an order under subsection (2) of this section, the court shall issue the order.
     (4) The department and the mother may enter an agreement in which the mother agrees to abstain from alcohol abuse or the nonprescription use of controlled substances and undergo random testing for such substances, or to submit to the involuntary use of pharmaceutical birth control or tubal ligation. If the department and the mother enter into an agreement under this subsection that the mother will abstain from alcohol abuse or the nonprescription use of controlled substances, undergo random testing by the department for such substances, and attend alcohol or drug dependency treatment programs and counseling as determined appropriate by the department, the department shall request the court to defer the entry of any order requiring the mother to submit to the involuntary use of pharmaceutical birth control or tubal ligation for as long as the mother continues to comply with the terms of the agreement, subject to the department's monitoring for compliance.

NEW SECTION.  Sec. 4   The department may request the court to dismiss the petition deferred under section 3 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 abused alcohol or used controlled substances in a nonprescription manner for at least thirty-six consecutive months.

NEW SECTION.  Sec. 5   The department shall pay for pharmaceutical birth control or tubal ligation administered under section 3 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 physician reports under section 2 of this act received by the department; (2) the number of cases where a physician has determined an infant is alcohol or drug-affected; (3) the number of cases where involuntary or voluntary use of pharmaceutical birth control measures or tubal ligation was implemented and whether pharmaceutical birth control or tubal ligation was utilized; and (4) the recidivism rate of subsequent births of alcohol or drug-affected infants.

NEW SECTION.  Sec. 6   Sections 1 through 5 of this act are each added to chapter 13.34 RCW.

NEW SECTION.  Sec. 7   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 takes effect July 1, 2005.