Pubdate: Fri, 04 May 2018
Source: Lexington Herald-Leader (KY)
Copyright: 2018 Lexington Herald-Leader
Author: John Cheves


To deal with an explosion in the number of Kentucky newborns exposed
to dangerous, addictive drugs by their pregnant mothers, lawmakers
this year added a section to House Bill 1, a measure that otherwise
streamlines the foster care system.

The section -- which becomes law in July, along with the rest of HB 1
- -- expands the definition of child abuse in Kentucky to include
neonatal abstinence syndrome.

Babies born with NAS go through withdrawal while they are still in the
hospital. They can experience trembling, excessive high-pitched
crying, seizures, vomiting and diarrhea. Some have more serious
problems, such as heart defects.

"I hold babies at the Children's Hospital in Louisville once a week,"
said state Rep. Joni Jenkins, D-Shively, one of the sponsors of HB

"Many of them are NAS babies. They are very unhappy babies. They are
very fidgety. You try to hold them and rock them and soothe them, but
- -- " Jenkins paused. "If you talk to the medical professionals in
those cases, I can tell you, they have very distinct opinions about
whether those babies should be going home with those parents."

With a finding of child abuse from NAS, termination of parental rights
could follow unless the mother enrolls in a drug addiction treatment
program within 90 days of the birth. At present, state caseworkers who
learn of NAS make recommendations to family court judges based the
circumstances of each individual case. Removing the baby is not the
automatic outcome.

The number of Kentucky babies born dependent on drugs has climbed from
46 in 2001 to 1,115 in 2016, according to hospital discharge data
collected annually by the Kentucky Cabinet for Health and Family
Services. The opioid crisis has made the problem far worse in recent
years as addiction to prescription painkillers and heroin has swept
the state.

Still, various medical groups, including the American Academy of
Pediatrics, have urged lawmakers not to "stigmatize" addiction for
pregnant women.

Criminal or civil penalties discourage women from seeking prenatal
care they need for fear of having their drug use discovered, critics
say. About half of the states treat drug use during pregnancy as child
abuse, according to a 2017 report from the Institute for Medicaid 

Backers of HB 1 said they tried to balance a number of conflicting
interests to be fair, but the child's safety is paramount.

"What we want here is for the mother to be in treatment," said state
Rep. David Meade, R-Stanford, the bill's lead sponsor.

"I'm sure that in most cases, the mothers will do whatever they have
to do to keep their families together. In the cases where they don't
make the effort, however, and there are drugs in the home, then
termination proceedings would begin," Meade said.

Foster parents who care for children removed from their homes worry
the new law might not be tough enough. Some of them said they have
accepted multiple drug-exposed babies from the same mothers, who
continued to use drugs while negotiating with caseworkers to get their
children returned.

"My question would be, where do you draw the line?" asked Melinda
McGuire, a foster mother in Rockcastle County. "I think it's a bad
idea for us to give someone a fresh start every time when we've seen
so many repeat occurrences."

"Do you get to ask them, 'Have you done this before? Is this child No.
1? Or is this child No. 3? Or is this child No. 5?'" McGuire said.
"Everyone is capable of making mistakes. We all make mistakes. But we
try to rectify those and do better. ... In our case, with the kids we
had in this one situation, each of the first four children had been
exposed, all down the line. My personal opinion is, that's not fair to
the child."
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