HOUSE MEMORIAL 3
56th legislature - STATE OF NEW MEXICO - second session, 2024
INTRODUCED BY
Stefani Lord and Jenifer Jones and Tara Jaramillo
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 ten live births being substance-exposed, one of the highest substance exposure rates in the country; 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 throughout their lives; and
WHEREAS, New Mexico is currently experiencing a crisis in the rise of fentanyl use and fentanyl pediatric exposure and record numbers of overdoses; 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, 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 substance-exposed infants and service referrals made; and
WHEREAS, in 2019, New Mexico instituted the federal Comprehensive Addiction and Recovery Act of 2016 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 safe 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, but stigma, shame and fear of legal ramifications deter women from seeking prenatal care; 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;
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 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 state's 2019 adoption of the federal Comprehensive Addiction and Recovery Act of 2016 plan of safe care and ongoing implementation;
B. review rates of the use of prenatal services and support by mothers who used drugs during pregnancy before the passage of the 2019 adoption of the federal Comprehensive Addiction and Recovery Act of 2016 plan of safe care 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 preventing 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 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. conduct a review of ways that other states implement plans of safe care;
J. conduct a review of states in which prenatal substance exposure constitutes a substantiated child abuse claim and subsequent intervention;
K. explore the provision of preventive services through community health workers;
L. conduct a comprehensive nationwide best practice review on evidence-based plans to reduce prenatal substance exposure;
M. study ways to increase access to emergency rental assistance, housing and financial resources for families with a substance-exposed newborn;
N. review long-term adverse outcomes of prenatal substance use;
O. study the lifetime fiscal impact of children born with prenatal substance exposure and neonatal abstinence syndrome;
P. study and provide recommendations on the feasibility of statewide prenatal substance screening;
Q. study the barriers to the provision and use of services and supports offered to mothers on plans of safe care;
R. review methods for improving hospital staff engagement with families to explain and collaboratively create a plan that is feasible for new parents; and
S. study what follow-up services are available to families in other states 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 services for pregnant and parenting women with substance use disorder, supporting continuing education for health care providers and determining effective 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 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 health care authority 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, 2025; 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 and the director of the children's cabinet.