Legislature(2005 - 2006)BUTROVICH 205
02/08/2006 01:30 PM HEALTH, EDUCATION & SOCIAL SERVICES
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SB 252-DEFINITION OF CHILD ABUSE AND NEGLECT CHAIR DYSON announced SB 252 to be up for discussion. 2:13:56 PM JOANNE GIBBENS, Program Administrator, Office of Children's Services (OCS), Department of Health and Social Services (DHSS), introduced herself and Stacie Kraly of the Department of Law. Ms. Gibbens explained that the intent of SB 252 is simply to comply with federal law. In 2003, the Keeping Children and Families Safe Act amended a federal law known as CAPTA, the Child Abuse Prevention and Treatment Act. An amendment to that federal law now requires states to have in place a process to investigate, provide services and look into cases where health care providers have reported issues to child protective services regarding illegal substance abuse and its effect on children. She said this bill therefore ensures that health care professionals report to the child protective service agency any infants affected by abuse of a controlled substance or by withdrawal from prenatal exposure to a controlled substance. Other parts of the federal law require that OCS develop a plan of care and so forth. All requirements in the federal amendment are things OCS does already, including receiving reports on a regular basis from hospital personnel if, for example, a baby is born who generates a concern about cocaine or marijuana exposure. The key piece of the legislation is putting into statute the requirement that health care providers make those reports. 2:16:05 PM SENATOR ELTON referred to an e-mail from the Alaska Primary Care Association expressing concern that the bill may discourage some people from going to a community health clinic. MS. GIBBENS acknowledged that people who fear being reported might not go to a health care provider for prenatal care. However, this bill, and the federal intent, is to ensure that it's the health care providers involved in the delivery or care of an infant who'll make that report. She indicated for OCS it's "safety first": if there is concern about an infant's health, the hope is that it's reported so necessary services can be provided. She discounted the notion that OCS would be standing at the doorway, waiting for the mother to give birth. She noted that hospitals and health care providers have their own protocols for determining when a situation has reached a level where the state should be involved, which is why OCS receives calls now and responds to them. Although not an expert in substance abuse itself, she emphasized that the bill is limited to the health care providers who have the expertise to judge whether there is harm to an infant. 2:19:19 PM SENATOR ELTON expressed surprise that there wasn't already a statutory requirement because of requirements for reporting instances of abuse. He asked whether perhaps the bill is needed because some people in the medical field aren't reporting now. MS. GIBBENS responded that she doesn't believe current child protection statutes specifically mention the use or effect of illegal or controlled substances on infants, including prenatal exposure or withdrawal; she deferred to Ms. Kraly for further detail. Ms. Gibbens said she'd consulted with a number of OCS offices in preparing for her testimony, and unanimously across the state those calls are being received. Although it's not specifically in law now, health care providers see it as their obligation to call so that OCS can be there to make an assessment, ensure the children are safe and perhaps get the mothers into treatment. Thus she didn't anticipate a large increase in calls due to this bill. 2:21:12 PM CHAIR DYSON offered his belief that when a parent is abusing illegal drugs, under current statute the child is identified as a child in need of aid. He asked Ms. Kraly whether detection of cocaine in an infant might precipitate the mother's arrest. STACIE KRALY, Chief Assistant Attorney General - Statewide Section Supervisor, Human Services Section, Civil Division, Department of Law (DOL), pointed out that she doesn't practice criminal law. She then opined that the referral would probably be made if a toxicology report showed the presence of a controlled substance in both the baby and the mother. There'd be a report of harm and also a referral to a law enforcement agency in order to determine whether charges would be brought; those are discretionary functions of the district attorneys in the areas they cover. She acknowledged the possibility, though she wasn't sure how often it happened. CHAIR DYSON referred to Senator Elton's concern and highlighted that providers want to get care to the right people and not scare off those who need it most. He asked what happens if prenatal care, including amniocentesis, raises a strong possibility of cocaine use before the child is born. 2:23:35 PM MS. KRALY responded that DOL is getting calls such as reports of harm relating to a mother's consuming controlled substances during a pregnancy. From a jurisdictional standpoint, neither OCS nor DOL has authority over an unborn child. From a program standpoint, however, the family is referred to OCS, [DOL] takes the report of harm, there is an assessment and there is an effort to provide services and work with the family prior to the child's birth in order to ameliorate difficulties or issues arising in the home. 2:24:48 PM CHAIR DYSON noted that Senator Green had joined the meeting at approximately 2:15 p.m. SENATOR GREEN referred to page 1, line 9, and asked whether it is grammatically correct. MS. KRALY agreed it is a clumsy sentence. She indicated DOL is working on an amendment to a companion bill in the House with the chair of the House Health, Education and Social Services Standing Committee to make it more readable. SENATOR ELTON observed that the bill is narrowly written, only applying to a health care provider involved in the delivery or care of an infant. It excludes the rest of the medical community, who also may be aware of circumstances. MS. GIBBENS related her understanding that this bill basically repeats, verbatim, what the federal law requires; she surmised it is due to the level of expertise of the health care providers who are at the delivery or who provide care to the baby. She noted, however, that all health care professionals are mandated reporters for child abuse and neglect in Alaska. 2:27:47 PM SENATOR ELTON requested that someone get back to him to explain why the bill is so narrow. He voiced concern about the ability of a medical professional to report if that professional doesn't fit the criteria but notices a problem. CHAIR DYSON asked whether anyone else wished to testify. He surmised that, in addition to bringing the statutes in line with current practice and federal requirements, this bill would affect federal funding. MS. GIBBENS or MS. KRALY concurred. In response to Senator Green, she said depending on how the language is finessed in the House Health, Education and Social Services Standing Committee, she'd propose that the Judiciary committee conform the language. 2:28:51 PM SENATOR GREEN moved to report SB 252 from committee with a zero fiscal note and a note to ask the Judiciary committee to look at conforming language. Without objection, SB 252 was reported from the Senate Health, Education and Social Services Standing Committee.