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House of Representatives
Session of 2017 - 2018 Regular Session

MEMORANDUM

Posted:	August 2, 2017 02:10 PM
From:	Representative Katharine M. Watson
To:	All House members
Subject:	Reporting of Substance-Exposed Infants

I soon will be introducing legislation that will require all cases of diagnosed substance-exposed newborns to be reported by health care providers to county child protective services, bringing Pennsylvania in line with existing federal law and reverting to state law as it existed prior to 2015. Pennsylvania’s Child Protective Services Law (CPSL) was amended in July of 2015 to create an exemption from the mandatory reporting requirement for health care providers involved in the delivery or care of a substance-exposed infant. Health care providers currently are not required to report substance-exposed infants in cases where the mothers, during their pregnancy, were using legally prescribed narcotics, such as oxycodone or methadone, if they took those drugs under the supervision of a medical professional. Specifically, Section 6386 of the CPSL (Mandatory reporting of children under one year of age) currently contains the following language, with the amendatory language italicized and boldfaced: “A health care provider shall immediately make a report or cause a report to be made to the appropriate county agency if the provider is involved in the delivery or care of a child under one year of age who is born and identified as being affected by any of the following: 1. Illegal substance abuse by the child's mother. 2. Withdrawal symptoms resulting from prenatal drug exposure unless the child's mother, during the pregnancy, was: i. under the care of a prescribing medical professional; and ii. in compliance with the directions for the administration of a prescription drug as directed by the prescribing medical professional. 3. A Fetal Alcohol Spectrum Disorder.” My legislation simply removes that exemption and reverts to the language of the CPSL prior to July of 2015: “A health care provider shall immediately make a report or cause a report to be made to the appropriate county agency if the provider is involved in the delivery or care of a child under one year of age who is born and identified as being affected by any of the following: 1. Illegal substance abuse by the child's mother. 2. Withdrawal symptoms resulting from prenatal drug exposure. 3. A Fetal Alcohol Spectrum Disorder.” This change would put Pennsylvania in compliance with existing federal law, (the Child Abuse Prevention and Treatment Act (CAPTA), which has consistently required reporting by health care providers to the appropriate child protection agency when an identified substance-exposed infant is affected by: 1. illegal substance abuse; or 2. withdrawal symptoms resulting from prenatal drug exposure, or 3. A Fetal Alcohol Spectrum Disorder. In addition to federal compliance, and more importantly, my legislation would accomplish three additional critical objectives: This puts the safety of infants first. I cannot abide sending any substance-exposed newborns (or any newborn, for that matter) home with mothers who by virtue of their substance abuse disorder are unable to properly care for the infant or who may put the infant in serious danger. My legislation would close a significant gap in reporting that currently exists. According to these startling PA Department of Human Services statistics, in 2015, the first year that DHS broke out data for substance-exposed infants, 2,350 newborns born to mothers on the Medicaid rolls in Pennsylvania were diagnosed with symptoms of withdrawal from narcotics, but only 707 of those infants were reported to child protective services. Last year, 2,100 newborns born to mothers on the Medicaid rolls were diagnosed with symptoms of withdrawal from narcotics, but only 972 of those infants were reported to child protective services. (The only data collected is on mothers covered by Medicaid. No agency collects substance-exposed newborn data on the privately insured, so the total number of substance-exposed infants in the Commonwealth is unknown.) My legislation would end the confusion that exists among health care providers as to when they are required to report these cases. In the interest of protecting our most vulnerable infants, I hope you can support this legislation by signing on to it as a co-sponsor.

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