At the Arizona Senate’s Health and Human Services Committee meeting last week, members narrowly passed House Bill 2530, which relates to substance use referrals for pregnant women, by a vote of four to three.
HB 2350 would require the Department of Child Safety (DCS) to provide communication they received involving substance use of a pregnant woman to the Arizona Health Care Cost Containment System (AHCCCS) to refer them to a provider for substance use treatment. The bill states that the communication DCS receives about a pregnant woman using substances may not always lead to an investigation of abuse or neglect.
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Rep. Rachel Jones (R – Maricopa) is sponsor of the bill and described how she has three children who were adopted from foster care, and how the mother of one of her children was pregnant with her second child and waited for DCS to take the child from her due to substance use.
“If she had had the option of getting help—being directed to getting treatment—I think that would’ve been a completely different scenario,” Jones said. “She is getting help now, but with the third child, she’s Navajo—she went up to the reservation to have that child so they wouldn’t take her.”
Jones said that her sponsored bill destigmatizes pregnant women who are using substances, and creates a pathway for needed services that would keep the mother and child together post-birth.
Concerns arose about having access to treatment services, specifically in rural communities, and the potential stigmatization and punishment of pregnant people. Melissa Compian, legislative liaison for DCS, addressed several concerns that were highlighted.
“We would receive a communication from the hotline. If there weren’t any other circumstances in the household or … concerns about children in the household, then the department would take that as a communication,” Compian said.
While DCS does not respond based on one single communication, the department does respond if a baby is born with a substance exposure. When that happens, healthcare providers alert DCS. The department then conducts a safety assessment of the child, which is when that single communication may be used. According to Compian, DCS looks at different options to take with the family to prevent the removal of the child.
Sen. Theresa Hatathlie (D – Tucson) asked if there would be a penalty for pregnant individuals who start services during pregnancy if their child is born with a substance exposure. Compian said in that instance, DCS would do a family assessment and look at participation in treatment to determine the safety of the child.
“While we do want to see pregnant people with substance use issues receive referrals for treatment, this bill adds additional burdens on DCS, and it’s not actually guaranteed this process will result in treatment or care for the unborn fetus,” said Gaelle Esposito, who represented the Arizona Chapter of the National Association of Social Workers.
Esposito stated that most pregnant people discontinue substance use during pregnancy on their own, while medical providers already refer pregnant people to substance use providers to receive treatment. She questioned what benefits DCS involvement would have during this process, and suggested that DCS involvement would dissuade pregnant people from seeking care in the first place due to fears of child removal. Esposito also brought up how there are not enough treatment facilities for pregnant people in the states to meet these needs.
During the end of the bill hearing, Hatathlie brought up the issue of Natives being taken to treatment and sober-living facilities under false pretenses, which sometimes ends in death.
“Real-life experiences have been shared with us regarding the fraudulent and predatory actions of rehabilitative treatment homes as well as sober living homes, and I’m wondering, how would this play out?” Hatathlie asked. “How many of those individuals get caught up in that type of situation? Is there any type of protection that’s involved for an individual that’s pregnant, just to make sure they’re going to be safe? And where is that advocacy there?”
Hatathlie wants to better-understand oversight and regulation, and was one of the committee members who was not in support of HB 2530.