HOUSE MEMORIAL 52

56th legislature - STATE OF NEW MEXICO - first session, 2023

INTRODUCED BY

Stefani Lord and William "Bill" R. Rehm and Jenifer Jones

 and David M. Gallegos

 

 

 

 

A MEMORIAL

REQUESTING THE SECRETARY OF HEALTH TO CONVENE A TASK FORCE TO STUDY THE PREVALENCE, EFFECTS AND LIFETIME FISCAL IMPACTS OF PRENATAL SUBSTANCE EXPOSURE AND ADVERSE NEONATAL OUTCOMES; REQUESTING THAT THE FINAL RESULTS OF THE STUDY BE REPORTED TO THE LEGISLATURE.

 

     WHEREAS, more than one thousand two hundred children are born in New Mexico each year, with nearly one in five live births being substance-exposed, one of the highest substance exposure rates in the country; and

     WHEREAS, nationally, one child is born with symptoms of withdrawal every fifteen minutes; and

     WHEREAS, the number of New Mexico newborns exposed to addictive substances in utero increased three hundred twenty-four percent between 2008 and 2017, and infants born exposed to addictive substances may struggle with health, learning and social challenges for the rest of their lives; and

     WHEREAS, New Mexico is currently experiencing an unforeseen crisis in the rise of fentanyl use and fentanyl pediatric exposure and record numbers of overdoses as the drug takes center stage in the opioid crisis; and

     WHEREAS, infants whose mothers used drugs during pregnancy are at risk for a range of physical, behavioral and cognitive problems, including: low birth weight, premature birth, vision and hearing loss, fine and gross motor development delays, sensory processing disorders, cognitive issues related to executive functioning, gastrointestinal tract and reflux issues and impaired pain sensation; and

     WHEREAS, substance exposure and substance withdrawal during early developmental stages can permanently alter brain functioning, which has lasting effects into adulthood, and effective prevention and intervention approaches are critical to averting such harm; and

     WHEREAS, since 2018, the United States children's bureau has collected information on the number of identified substance-exposed infants, as well as the amount of service referrals made; and

     WHEREAS, to help seek better lives for newborn babies and addicted parents, in 2019, New Mexico instituted the federal Comprehensive Addiction and Recovery Act of 2016 and plan of safe care program to keep mothers and babies together with supportive services; and

     WHEREAS, according to the children, youth and families department, from 2020 to 2021, nine infants with a plan of care or notification died within their first year, and many of those cases were also reported for child abuse; and

     WHEREAS, early identification and intervention reduce adverse outcomes of prenatal substance use, such as preterm birth and low birth weight, but stigma, shame and fear of legal ramifications deter women from seeking prenatal care; and

     WHEREAS, the New Mexico legislature established in Section 32A-1-3 NMSA 1978 the purpose "to provide for the care, protection and wholesome mental and physical development of children coming within the provisions of the Children's Code"; and

     WHEREAS, nationally, it is reported that a child born with prenatal substance exposure could cost a state two million dollars ($2,000,000), from birth to age eighteen, per child; and

     WHEREAS, the New Mexico legislature strives to ensure positive outcomes for children; and

     WHEREAS, there is a critical need to address this crisis for the most vulnerable population in the state;

     NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the secretary of health be requested to convene a task force to make recommendations and to study the independent and combined effects of prenatal drug exposure on birth outcomes for children in New Mexico; and

     BE IT FURTHER RESOLVED that the task force be requested to:

          A. study the efficacy and outcomes of the 2019 adoption of the federal Comprehensive Addiction and Recovery Act of 2016 plan and ongoing implementation;

          B. review rates of the use of prenatal services and support by mothers who used drugs during pregnancy before the 2019 plan of care was passed and since its implementation;

          C. conduct a longitudinal study on rates of substance-exposed newborns in New Mexico over the last twenty years;

          D. review planning and coordination of activities related to prenatal substance exposure and neonatal abstinence syndrome;

          E. research the factors that may contribute to an increased likelihood of a pregnant person engaging in substance use during pregnancy and what evidence-based support or alternative and prevention methods exist to reduce these rates;

          F. study and develop recommendations for the prevention, identification and treatment of neonatal abstinence syndrome;

          G. study and develop recommendations for the prevention, identification and treatment of opioid use disorder in pregnant women;

          H. review relevant infant mortality cases;

          I. review safe sleep practices and infant deaths;

          J. conduct a comprehensive nationwide best practice review of ways that other states implement plans of safe care for infants with prenatal substance exposure and their families;

          K. conduct a comprehensive nationwide review of states in which prenatal substance exposure constitutes a substantiated child abuse claim and what happens next;

          L. study implicit bias and beliefs that prenatal substance use necessitates an automatic referral to child protective services;

          M. conduct a comprehensive nationwide best practice review of state statutes on whether instances of substance use while pregnant are automatically referred to child protective services for an investigation;

          N. explore alternative means of preventive service provision through community health workers;

          O. conduct a comprehensive nationwide best practice review on evidence-based plans to reduce prenatal substance exposure;

          P. study ways to increase access to emergency rental assistance, housing and financial resources for families with a substance-exposed newborn;

          Q. review long-term adverse outcomes of prenatal substance use;

          R. study the lifetime fiscal impact of children born with prenatal substance exposure and neonatal abstinence syndrome;

          S. study and provide recommendations on the feasibility of statewide prenatal substance screening in New Mexico;

          T. study the barriers to services and supports offered to mothers on plans of care in the 2021 Comprehensive Addiction and Recovery Act of 2016 review evaluation;

          U. review how to increase hospital staff engagement with families to collaboratively create a plan of care, explain the plan of care and advise that care coordinators with managed care organizations will contact them;

          V. review best practices to ensure that the timing of a plan of care creation at delivery is feasible for new parents; and

          W. study what, if any, follow-up services are available by national best practices once a newborn who was exposed to prenatal substance abuse has been discharged from the hospital; and

     BE IT FURTHER RESOLVED that the task force be requested to develop a data-driven implementation plan, focusing on preventing prenatal opioid exposure, providing evidence-based treatment for both mothers and infants, increasing the accessibility of family-friendly services for pregnant and parenting women with substance use disorder, supporting continuing education for health care providers and determining optimal family and developmental support services for children who have experienced prenatal substance exposure; and

     BE IT FURTHER RESOLVED that the task force be requested to involve input from appropriate stakeholders and relevant agencies, including:

          A. experts in pediatric and neonatal medicine;

          B. a representative of the 2021 New Mexico department of health evaluation team of the 2021 Comprehensive Addiction and Recovery Act of 2016;

          C. a member of the J. Paul Taylor early childhood task force;

          D. a member of the New Mexico social work task force;

          E. representation from the children, youth and families department, the department of health, the human services department and the early childhood education and care department;

          F. a first responder with emergency medical services experience;

          G. experts with experience in medicaid managed care organizations;

          H. an expert with experience in hospital management;

          I. an expert on the Children's Code;

          J. a licensed independent social worker with experience in child welfare;

          K. an expert from a nonprofit children's advocacy organization;

          L. an expert in behavioral health services;

          M. two or more persons with lived experience;

          N. a representative of a gender minority community;

          O. a representative from the office of the attorney general;

          P. an expert on New Mexico's Indian Family Protection Act; and

          Q. other stakeholders whose expertise the secretary of health deems necessary to the work of the task force; and

     BE IT FURTHER RESOLVED that the task force be requested to enter into an agreement with an institution of higher education to perform research that supports the task force's work; and

     BE IT FURTHER RESOLVED that those findings and recommendations of the task force be presented to the legislative health and human services committee by August 1, 2024; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the governor, the attorney general, the chair of the legislative health and human services committee, the director of the legislative finance committee, the appropriate cabinet secretaries, the director of the children's cabinet and public postings.

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