Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H4392 Compare Versions

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1	1	HOUSE . . . . . . . . No. 4392
2	2	The Commonwealth of Massachusetts
3	3	________________________________________
4	4	HOUSE OF REPRESENTATIVES, February 15, 2024.
5	5	The committee on Children, Families and Persons with Disabilities, to
6	6	whom were referred the petition (accompanied by bill, Senate, No. 64) of
7	7	Joanne M. Comerford and Jason M. Lewis for legislation to support
8	8	families, the petition (accompanied by bill, Senate, No. 129) of John C.
9	9	Velis for legislation relative to medication-assisted treatment, the petition
10	10	(accompanied by bill, House, No. 166) of Carole A. Fiola and others
11	11	relative to substance exposed newborns and the petition (accompanied by
12	12	bill, House, No. 173) of Sean Garballey and others for legislation to
13	13	protect infants affected by in-utero substance exposure or fetal alcohol
14	14	spectrum disorder, reports recommending that the accompanying bill
15	15	(House, No. 4392) ought to pass [Representatives Berthiaume of Spencer
16	16	and Sullivan-Almeida of Abington dissent].
17	17	For the committee,
18	18	JAY D. LIVINGSTONE. 1 of 6
19	19	FILED ON: 2/7/2024
20	20	HOUSE . . . . . . . . . . . . . . . No. 4392
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Third General Court
24	24	(2023-2024)
25	25	_______________
26	26	An Act relative to substance exposed newborns.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Section 51A of chapter 119 of the general laws is hereby amended in
30	30	2subsection (a) in the first paragraph by striking out the words:-
31	31	3 (iii) physical dependence upon an addictive drug at birth,
32	32	4 SECTION 2. Said section 51A is hereby further amended by inserting after subsection (a)
33	33	5the following new subsection:-
34	34	6 (a ½) An indication of prenatal substance exposure does not, in of itself, meet the
35	35	7requirements of subsection (a). The Department of Public Health shall promulgate regulations
36	36	8and guidance in consultation with the Department of Children and Families under Section 51L of
37	37	9Chapter 111 of the general laws as to how substance exposure shall be weighed in determining
38	38	10whether to file a report, including any instances in which prenatal substance exposure from a
39	39	11medication prescribed by a licensed healthcare provider may be considered in filing a report. 2 of 6
40	40	12 SECTION 3. Chapter 111 of the general laws is hereby amended by inserting in Section 1
41	41	13the following:
42	42	14 “Plan of Safe Care”, a family care plan designed to ensure the safety and well-being of an
43	43	15infant with prenatal substance exposure following his or her release from the care of a healthcare
44	44	16provider by addressing the health and substance use treatment needs of the infant and affected
45	45	17family or caregiver.
46	46	18 SECTION 4: Chapter 111 of the general laws is hereby amended by inserting after
47	47	19section 51K the following section:-
48	48	20 Section 51L. (a) The Department of Public Health in consultation with the Department of
49	49	21Children and Families shall promulgate regulations and corresponding guidance for all
50	50	22healthcare providers who care for perinatal patients and/or newborns detailing the roles and
51	51	23responsibilities of staff related to the requirement that healthcare providers must:
52	52	24 (1) Screen for prenatal substance exposure using a validated questionnaire and provide
53	53	25brief intervention, treatment initiation, and referral as clinically indicated;
54	54	26 (2) Notify the Department of Public Health of all births of infants who were prenatally
55	55	27exposed to substances pursuant to the requirements of the federal Child Abuse Prevention and
56	56	28Treatment Act and the protocols described in this section;
57	57	29 (3) Prior to postnatal discharge, determine whether to file a report of suspected child
58	58	30abuse or neglect as required by section 51A of chapter 119 and identify if a plan of safe care, as
59	59	31defined in section 1 of chapter 111, has been developed; 3 of 6
60	60	32 (4) Assess family needs, develop a plan of safe care if indicated, and refer families to
61	61	33appropriate services, as directed by the Department of Public Health and pursuant to the federal
62	62	34Child Abuse Prevention and Treatment Act.
63	63	35 (b) The Department of Public Health shall develop a plan to receive notifications of
64	64	36substance exposed births, as defined in regulation under subsection (a) of this section, directly
65	65	37from healthcare providers and shall collect data for reporting in a manner that is in compliance
66	66	38with the federal Child Abuse Prevention and Treatment Act.
67	67	39 (c) The Department of Public Health shall establish a program to ensure perinatal
68	68	40individuals, families, and providers have access to services designed to support the development
69	69	41and implementation of an effective plan of safe care, including services addressing the health and
70	70	42substance use disorder treatment needs of the infants and affected family or caregivers, as
71	71	43required by the federal Child Abuse Prevention and Treatment Act. Said program shall include a
72	72	44central system perinatal individuals, families and providers can contact to receive information
73	73	45and referrals, as well as a system of community-based services to meet the behavioral health,
74	74	46parenting, and child development needs of families affected by substance use and substance use
75	75	47disorders, subject to appropriation.
76	76	48 (d) The Department of Children and Families shall provide, and the Department of Public
77	77	49Health shall receive, submissions of data from the Department of Children and Families to the
78	78	50Public Health Data Warehouse in order to facilitate ongoing quality assurance and evaluation
79	79	51projects related to this statute and other family-service initiatives.
80	80	52 (e) The Department of Public Health shall provide date to the Department of Children
81	81	53and Families on all births of infants who were prenatally exposed to substances in a form and 4 of 6
82	82	54manner that is complaint with the requirements of the federal Child Abuse Prevention and
83	83	55Treatment Act, provided that said data shall not include personally identifiable information.
84	84	56 (f) There may be a multidisciplinary standing committee established for the purpose of
85	85	57advising the Department of Public Health in matters related to prenatal substance exposure,
86	86	58maternal and child health, treatment of substance use disorder, and racial equity in access to
87	87	59healthcare, and includes at least one child focused professional. This advisory committee shall
88	88	60consist of seven persons appointed by the governor with one representative from each of the
89	89	61following organizations: the Massachusetts Medical Society, the Massachusetts Health and
90	90	62Hospital Association, Massachusetts Organization for Addiction Recovery, the Massachusetts
91	91	63branches of the National Association for the Advancement of Colored People New England Area
92	92	64Conference, the Massachusetts chapter of the National Association of Social Workers, the
93	93	65Committee for Public Counsel Services, and the Massachusetts chapter of the American
94	94	66Congress of Obstetricians and Gynecologists. The committee shall make recommendations to the
95	95	67Department of Public Health, based on research and analysis, to ensure that all regulations: (i)
96	96	68reflect current accepted standards of healthcare and substance use treatment practices; (ii)
97	97	69conform to the reporting requirements under the federal Child Abuse Prevention and Treatment
98	98	70Act; and (iii) do not create racial disparities in maternal and child healthcare, reports of suspected
99	99	71child abuse or neglect under section 51A of chapter 119, or number of patients identified for
100	100	72plans of safe care as defined in section 1 of chapter 111.
101	101	73 SECTION 5. (a) The department of the children and families, in consultation with the
102	102	74department of public health and the office of the child advocate, shall develop a report to study
103	103	75the impact of this legislation on child and family safety and well-being. The departments shall
104	104	76consider: 5 of 6
105	105	77 (1) Any impact, positive or negative, the changes may have had on racial and ethnic
106	106	78disparities;
107	107	79 (2) Any impact the statutory changes may have had on child safety;
108	108	80 (3) Any impact the statutory changes may have had on child well-being;
109	109	81 (4) Gaps in infant and parent services; and
110	110	82 (5) Any additional statutory or regulatory changes that may be needed.
111	111	83 (b) The report shall include, but not be limited to:
112	112	84 (1) An examination of child abuse and neglect reports related to an infant’s exposure at
113	113	85birth to substances, including those that were ultimately screened out by the department of
114	114	86children and families;
115	115	87 (2) An examination of longitudinal custodial, developmental, and service provision
116	116	88outcomes of infants who were reported to be exposed to substances at birth that did not result in
117	117	89a child abuse and neglect report;
118	118	90 (3) An examination of child abuse and neglect reports made under Section 51A of chapter
119	119	91119 related to an infant’s exposure at birth to substances;
120	120	92 (4) The demographics, including race and ethnicity, of both the child and the parents that
121	121	93are the subject of reports described in clauses (1) through (3).
122	122	94 (c) If feasible, said report shall include relevant aggregate quantitative data on all cases
123	123	95that meet the criteria specified in subsection (b)(1) and (b)(2) above, as well as a qualitative 6 of 6
124	124	96analysis that includes a review of case notes in the database maintained by the department of
125	125	97children and families for a sample of cases.
126	126	98 (d) No later than 18 months after the effective date of this legislation the department of
127	127	99children and families, shall file an interim report of its findings with the clerks of the senate and
128	128	100house of representatives, the senate committee on ways and means, the house committee on ways
129	129	101and means, the joint committee on children, families, and person with disabilities, and the joint
130	130	102committee on mental health, substance use and recovery.
131	131	103 (e) No later than three years after the effective date of this legislation, the department of
132	132	104children and families shall file a final report of its findings with the clerks of the senate and
133	133	105house of representatives, the senate committee on ways and means, the house committee on ways
134	134	106and means, the joint committee on children, families, and person with disabilities, and the joint
135	135	107committee on mental health, substance use and recovery.
136	136	108 SECTION 6. Sections 1 and 2 shall be effective eighteen months after the passage of this
137	137	109legislation.
138	138	110 SECTION 7. Sections 3 and 4 shall be implemented and effective twelve months after the
139	139	111passage of this legislation.
140	140	112
141	141	113