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Maine Bill's Proposed Fetal Exposure Guidelines Generate Controversy
02/27/2013   Reported By: Patty B. Wight

A proposed bill in Augusta seeks to clarify the circumstances under which health care providers should report cases of newborns who have been exposed to drugs and alcohol in the womb.  Maine lawmakers took up the measure today at a public hearing before the Health and Human Services Committee.  Patty Wight reports.

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Originally Aired: 2/27/2013 5:30 PM

The bills' sponsor is Rep. Richard Malaby of Hancock, who recounted a story about a woman he met on the campaign trail who he says raised his awareness of Neonatal Abstinence Syndrome - or NAS. 

"An elderly woman came up to me and said, 'Do you know what I do?'  And I said, 'No ma'am.'  And she said, 'I'm a hugger. I go to Eastern Maine Medical Center and hold these NAS babies a couple days a week.  And furthermore, when I do that, the parents come in, and the parents often-times are addicted.'  And she noted, so too, frequently, are the grandparents.  And I thought, 'Good for her.  Bad for us,'" Malaby recalled.

In 2005, The number of drug-affected Maine babies was under 200.  By the beginning of 2012, it was nearly 700.  It's unclear whether the number reflects an actual increase or just better identification, but Malaby would like to see it lowered.

His bill aims to do that by requiring health care providers to report babies from birth to 12 months of age who exhibit signs of potential fetal exposure to alcohol to the Department of Health and Human Services.  The idea is that addicted parents can then access services.

But the requirement to report "potential exposure" has raised concerns.  Democratic Rep. Ann Dorney, a family physician who practices in Skowhegan, asked whether the law would apply to mothers who, say, smoked marijuana before they realized they were pregnant, but then stopped.

"It's the same issue that happens frequently - someone drank alcohol, they had a glass of wine before they found out they were pregnant.  And that happens very frequently," she said.  "And if you did this, you would have to say, they would have to report all those patients." 

Therese Cahill-Low, the director of DHHS's Office of Child and Family Services, stressed that the bill seeks to help families, and  eliminates a previous requirement that the department investigate every report of potential abuse. 

"We want to support families. and regardless of whether or not that baby goes home looking fine, the parents might need some additional support down the road, and that's really where our office comes into play," she said.  "I think our office at this point has a reputation of only wanting to take children into care, and that is absolutely, positively false." 

While the intent of the bill may be to help parents struggling with addiction, Jill Barkley from the Maine ACLU says it will likely have the opposite effect because it treats parents as criminals.

"In my previous career, I worked with countless Maine women who lived in fear of losing custody for seeking help with relationship abuse, drug abuse, or substance abuse," she said.

Further, Barkley said, the bill is an overreach of the law because it requires doctors and nurses to file reports based on mere suspicions. 

But Republican Rep. Deb Sanderson challenged the notion that the bill would derail efforts to help families, especially given the fact that just because they're reported doesn't mean they'll be investigated. "Don't you feel as though this may open the pathway for parents who are pregnant, or potentially, just delivered to seek the help they need? " she said.

Angela Westhoff, the Executive Director of the Maine Osteopathic Association, doesn't think so.

"If an honest mother who discloses use while being pregnant receives aggressive and potentially punitive supervision and a more secretive mother would avoid identification, this would perhaps incentivize non-disclosure and quick discharge rather than the prolonged monitoring that would happen for high-risk infants," Westhoff said.

After an hour of testimony, the hearing ended with no obvious sign of which way the committee might be leaning. Bill sponsor Richard Malaby says he was clearly mistaken when he thought his bill was going to be a simple house-keeping measure.  "And I thought this was going to be easy."

The committee will hash out the details of the bill next week in a scheduled work session.



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