PRINTER'S NO. 1368
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE RESOLUTION
No.
231
Session of
2024
INTRODUCED BY SCHWANK, J. WARD, HUGHES, TARTAGLIONE, FONTANA,
CAPPELLETTI, COSTA, COMITTA, BAKER AND KANE,
FEBRUARY 12, 2024
REFERRED TO HEALTH AND HUMAN SERVICES, FEBRUARY 12, 2024
A RESOLUTION
Directing the Joint State Government Commission to establish an
advisory committee and conduct a comprehensive study
regarding the effectiveness of the Commonwealth's
multidisciplinary approach to infants born affected by
substance use or withdrawal symptoms resulting from prenatal
drug exposure or a fetal alcohol spectrum disorder, including
the success with or barriers to developing plans of safe care
as required by Federal and State law.
WHEREAS, In 2021, the Department of Health reported that more
than 1,600 infants met the department's case definition of
Neonatal Abstinence Syndrome (NAS) with more than 90% of the
diagnoses linked to opioid exposure; and
WHEREAS, In 2021, more than 7,000 infants in this
Commonwealth were referred to a county child welfare agency for
concerns related to parental substance use or being a substance-
affected infant, accounting for approximately 60% of all general
protective service referrals involving infants; and
WHEREAS, Challenges exist in reliably tracking and reporting
on outcomes for infants, including how many receive a plan of
safe care and what types of services or supports are woven into
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such a plan, how many infants are placed in foster or kinship
care, referred to and tracked through early intervention or
receiving services outlined with the Commonwealth's contracts
with Medicaid managed care organizations; and
WHEREAS, A growing number of infants with prenatal substance
exposure referred to the Department of Human Services by health
care professionals, as required by Federal and State law, are
being classified information only, a status undefined in law,
not subject to any tracking by the department and outside any
measured outcomes; and
WHEREAS, The Federal Child Abuse Prevention and Treatment Act
and Pennsylvania Child Protective Services Law recognize that
substance use during pregnancy, in and of itself, and an infant
being born affected by prenatal exposure are appropriately
excluded from definitions of child abuse or neglect; therefore
be it
RESOLVED, That the Senate direct the Joint State Government
Commission to establish an advisory committee and conduct a
comprehensive study regarding the effectiveness of the
Commonwealth's multidisciplinary approach to infants born
affected by substance use or withdrawal symptoms resulting from
prenatal drug exposure or a fetal alcohol spectrum disorder,
including the success with or barriers to developing plans of
safe care as required by Federal and State law; and be it
further
RESOLVED, That the advisory committee be comprised of the
following:
(1) The Secretary of Drug and Alcohol Programs or a
designee who shall be an employee of the Department of Drug
and Alcohol Programs.
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(2) The Secretary of Health or a designee who shall be
an employee of the Department of Health.
(3) The Secretary of Human Services or a designee who
shall be an employee of the Department of Human Services.
(4) The executive director of the Center for Rural
Pennsylvania or a designee.
(5) A representative from the Center for Children's
Justice.
(6) A member of the Behavioral Health Council.
(7) A member of the Pennsylvania Perinatal Quality
Collaborative.
(8) A parent who has experienced receiving treatment
services for substance use disorder.
(9) An employee of a county Children and Youth Services.
(10) Other individuals and organizations selected by the
Joint State Government Commission;
and be it further
RESOLVED, That the advisory committee, in conducting the
study, do all of the following:
(1) Conduct a thorough review from families as to what
they identify as the real or perceived challenges with plans
of safe care and access to clinically appropriate substance
use disorder treatment and recovery services during pregnancy
and the postpartum period.
(2) Evaluate feedback from interdisciplinary
professionals, including stakeholders from health care, child
welfare, early intervention and substance use treatment
professionals regarding plans of safe care and
recommendations for improved outcomes for infants and their
families.
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(3) Develop strategies to address the existing
duplication resulting from health care providers being
required to make two distinct notifications, one to the
Department of Health for infants meeting the Neonatal
Abstinence Syndrome case definition and the other to the
Department of Human Services for infants born affected by
prenatal substance exposure, ensuring that any recommended
new approach be grounded in public health toward limiting, as
appropriate, contact with and referrals to the child welfare
system.
(4) Assess outcomes currently measured, including
whether infants, with or without a plan of safe care in
place, are being referred to and tracked as part of the
Commonwealth's early intervention system, participating in
evidence-based home visiting or family centers, receiving
services as outlined in the Medicaid managed care contracts
or discovered in other databases such as trauma registry,
adoption and foster care, protective services and child
death.
(5) Provide projections of or actual costs related to
the identification of the infants, notification to the
Department of Health and the Department of Human Services
about the infants and creating plans of safe care for
infants, including any spending as part of Medicaid managed
care organizations.
(6) Identify how policy, practice, funding priorities
and outcomes measured align or are in conflict across
interdisciplinary local and State publicly funded agencies
and to what degree the policy, practice or funding is
directed to supporting infants and families within a
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hospital-based versus community-based setting throughout the
first year of the infant's life and mother's postpartum
period.
(7) Document innovative strategies and successful
information sharing and collaboration, including through
memoranda of understanding.
(8) Evaluate existing or needed State-level strategies
to prevent infant and young child morbidity and mortality;
and be it further
RESOLVED, That the advisory committee issue a report of its
findings to the Senate no later than 18 months after the
adoption of this resolution.
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