SB 408 introduced by Senators Becker and Miller addresses “neonatal abstinence syndrome” which is defined as “the various adverse effects that occur in a newborn infant who was exposed to addictive illegal or prescription drugs while in the mother’s womb. It would require the issuance of rules imposing various reporting requirements for hospitals to report neonatal abstinence syndrome data to the Department of Health. The rules would eventually include an appropriate definition of a neonatal abstinence syndrome diagnosis, methodology for testing newborn infants, and practices for detecting drug abuse by pregnant women.
The legislation would prohibit disclosure of data gathered under this law to law enforcement agencies for criminal prosecution and disclosure to the department of child services for purposes of terminating parental rights or declaring the infant a child in need of services.
This legislation flirts with the fine line of attempting to promote infant health on the one side and, on the other, viewing women as untrustworthy but necessary vessels for carrying infants. Maybe what bothers me most is the narrow focus on addictive drugs. I suppose I would have a better feel for this legislation if there was a broader approach of figuring out how to improve the health of pregnant women (e.g. the best sorts of prenatal care to subsidize).
Now, Doug, let’s not be too hasty in this. In 2007, we ranked 16th in infant deaths and 21st in neonatal deaths. That wasn’t at the bottom yet, so if we just ease into this by talking about addictive drugs–excluding alcohol which is the most abused drug and cause of numerous problems–maybe the legislature will go for that and consider it a good way to control and snoop on minorities, because as we all know, white people don’t abuse drugs. (We should ignore the fact that Indiana scored 9th in neonatal deaths, because we don’t have any data comparing all the states for black children.)
This could be a difficult implementation given the HIPAA Privacy rules. A covered entity (hospitals being the main one), cannot disclose patient information except for certain exceptions. The most notable exceptions are to facilitate care or to report a crime to law enforcement. I took a quick peek and saw nothing for studies or research. Any data collected would have to be aggregated/anonymized. We all know how easy data breaches or mistakes occur, even Google makes them with some frequency. Accidental disclosure or poorly thought out data strategies could get expensive for the hospital. For example, they may strip out names and such, but the study is going to want some geographic dimension, like a zip code. In rural areas, matching a zip code with births in the time frame studied and facts about the infant or mother could lead to identification.
My sense, as someone who is familiar with the analytical techniques required for this sort of thing, is that if you anonymize the analytical set sufficiently, you will have little left to conduct an adequate study, and the whole thing is just a waste of state budget and hospital expense (which obviously is passed on to paying patients).
I live in Huntington, West Virginia, where the number of babies born exposed to drugs is one in thirteen. Yes. You read that correctly. 1 out of every 13 babies in our community is chemically dependent at birth. Due to the sheer number of babies and overcrowding at our local hospital, our community has created Lily’s Place, a stand-alone drug rehab center for newborn babies. Our opening will take place early this year, and I invite you to read about our efforts at http://www.lilysplace.org. I don’t comment here to toot our own horn, but we want other communities dealing with this issue to know that positive outcomes are possible using therapeutic handling techniques, drug therapy and a whole lot of love. The babies are diagnosed using parent disclosure and testing of cord blood. Once they are stable on their wean, they are transferred to Lily’s Place from the hospital. Babies are weaned in a home-like environment while parents are linked to the programs they need. We are the only facility of our kind in the nation. Typically our babies (per state CPS) go home with their family of origin. Addiction crosses race, gender, socio-economic and geographical lines.
Blessings to you guys as you figure out what’s best for you. This is a tough issue, and it’s not going away. Remember: The only story sadder than a baby born “addicted” is the story of what lead that same baby’s mother to abuse drugs in the first place.