Exclusive: States Need U.S. Help to Protect Drug-Affected Infants – GAO

A used needle sits on the ground in a park in Lawrence
A used needle sits on the ground in a park in Lawrence, Massachusetts, U.S., May 30, 2017. REUTERS/Brian Snyder

By Duff Wilson
NEW YORK (Reuters)

The federal government needs to take more steps to help states protect infants born affected by drugs such as opioids, the U.S. Government Accountability Office says in a new report released Wednesday

State agencies remain confused about a federal law requiring them to report drug-affected infants to child protective services – not to punish mothers but to help families and ensure the child’s safety, the GAO says. Thirty-eight states said more guidance would be “extremely to very helpful,” according to the report.



The GAO report was sparked by a 2015 Reuters investigation showing a growing number of newborns diagnosed with drug-withdrawal syndrome from opioids. Thousands of infants were sent home from hospital without the “plan of safe care” required by a 2003 federal law, the news agency found. (Read the Reuters investigation)

Reuters also found 110 cases of children since 2010 who were exposed to opioids while in the womb and who later died preventable deaths at home. Those deaths were largely accidental but typically at the hand of a parent battling addiction.


The report comes on the eve of a U.S. Senate committee hearing Thursday on opioids and children

Senator Robert Casey of Pennsylvania, the top Democrat on the children and families subcommittee, requested the report. He said he is drafting legislation for a grant program to help families dealing with opioid addiction.

“Every player in this effort has to be part of the strategy to focus on infants,” Casey said in an interview Wednesday.



Absent a specific threat to a newborn’s safety, the GAO found, some hospitals and state agencies don’t want to inform child protective services about infants born with drugs in their systems, so long as the mother is taking prescribed opioids such as methadone or hydrocodone.

“Health-care providers tend to view child welfare involvement as punitive rather than a potential resource for the family,” one state official told the GAO, the watchdog arm of Congress. Another said reporting those cases would “further strain limited resources” on “infants at low risk of abuse or neglect.”

In a response contained in the report, the Department of Health and Human Services rejected the GAO’s recommendation of greater federal guidance, saying it was already doing enough to advise states.


The health agency said states needed “flexibility” to decide which infants are “affected by” substance abuse and to define a “plan of safe care

Child safety advocates remain concerned.

“States are sending up so many distress signals, and the federal government seems oblivious,” said Cathleen Palm, founder of the nonprofit Center for Children’s Justice in Pennsylvania.



Stephen Patrick, a Vanderbilt University pediatrics expert, is scheduled to testify at the Senate committee hearing. “Our efforts focused on pregnant women and infants impacted by the opioid epidemic need to be better coordinated and funded,” Patrick said.

Former U.S. Representative Jim Greenwood, a Republican from Pennsylvania who proposed the 2003 federal law for babies born affected by drugs, said every state needs to ensure that those cases are reported to child protective services.

“They are the ones who can help these mothers find the social services they need for their babies to be safe,” he said.


(Reported By Duff Wilson. Edited by Blake Morrison.)