HR 78 — A Resolution directing the Joint State Government Commission to establish an advisory committee and conduct a comprehensive study regarding the effectiveness of the Commonwealth's multidisciplinary approach to infants born affected by substance use or withdrawal symptoms resulting from prenatal drug exposure or a fetal alcohol spectrum disorder, including the success with or barriers to developing plans of safe care as required by Federal and State law.

PRINTER'S NO.   680

                  THE GENERAL ASSEMBLY OF PENNSYLVANIA



           HOUSE RESOLUTION
              No. 78
                                                 Session of
                                                   2025

     INTRODUCED BY CEPEDA-FREYTIZ, BRENNAN, SANCHEZ, HILL-EVANS,
        SCHLOSSBERG, FREEMAN, CERRATO, HOWARD, KENYATTA, GIRAL,
        OTTEN, D. WILLIAMS AND GREEN, FEBRUARY 20, 2025

     REFERRED TO COMMITTEE ON HUMAN SERVICES, FEBRUARY 20, 2025


                                  A RESOLUTION
 1   Directing the Joint State Government Commission to establish an
 2      advisory committee and conduct a comprehensive study
 3      regarding the effectiveness of the Commonwealth's
 4      multidisciplinary approach to infants born affected by
 5      substance use or withdrawal symptoms resulting from prenatal
 6      drug exposure or a fetal alcohol spectrum disorder, including
 7      the success with or barriers to developing plans of safe care
 8      as required by Federal and State law.
 9      WHEREAS, For 2022, the Department of Health reported that
10   more than 1,200 infants met the department's case definition of
11   Neonatal Abstinence Syndrome, with more than 90% of the
12   diagnoses linked to opioid exposure; and
13      WHEREAS, Concerns related to parental substance use or being
14   a substance-affected infant account for approximately 60% of all
15   general protective service referrals involving infants; and
16      WHEREAS, There were 424 valid concerns for children under one
17   year old who had withdrawal symptoms or were born affected by
18   drug exposure in 2023; and
19      WHEREAS, State law requires medical professionals to initiate
20   a program of safe care for an infant affected by prenatal
 1   substance use, and 377 substance-affected infants were placed
 2   into a plan of safe care in 2023; and
 3      WHEREAS, Challenges exist in reliably tracking and reporting
 4   on outcomes for infants, including what types of services or
 5   supports are woven into a plan of safe care and how many infants
 6   are placed in foster or kinship care, referred to and tracked
 7   through early intervention or receiving services outlined with
 8   the Commonwealth's contracts with Medicaid managed care
 9   organizations; and
10      WHEREAS, A growing number of infants with prenatal substance
11   exposure referred to the Department of Human Services by health
12   care professionals, as required by Federal and State law, are
13   being classified information only, a status undefined in law,
14   not subject to any tracking by the department and outside any
15   measured outcomes; therefore be it
16      RESOLVED, That the House of Representatives direct the Joint
17   State Government Commission to establish an advisory committee
18   and conduct a comprehensive study regarding the effectiveness of
19   the Commonwealth's multidisciplinary approach to infants born
20   affected by substance use or withdrawal symptoms resulting from
21   prenatal drug exposure or a fetal alcohol spectrum disorder,
22   including the success with or barriers to developing plans of
23   safe care as required by Federal and State law; and be it
24   further
25      RESOLVED, That the advisory committee be composed of the
26   following:
27             (1)   The Secretary of Drug and Alcohol Programs or a
28      designee who shall be an employee of the Department of Drug
29      and Alcohol Programs.
30             (2)   The Secretary of Health or a designee who shall be

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 1      an employee of the Department of Health.
 2          (3)     The Secretary of Human Services or a designee who
 3      shall be an employee of the Department of Human Services.
 4          (4)     The executive director of the Center for Rural
 5      Pennsylvania or a designee.
 6          (5)     A representative from the Center for Children's
 7      Justice.
 8          (6)     A member of the Behavioral Health Council.
 9          (7)     A member of the Pennsylvania Perinatal Quality
10      Collaborative.
11          (8)     A parent who has experienced receiving treatment
12      services for substance use disorder.
13          (9)     An employee of a county Children and Youth Services.
14          (10)     Other individuals and organizations selected by the
15      Joint State Government Commission;
16   and be it further
17      RESOLVED, That the advisory committee, in conducting the
18   study, do all of the following:
19          (1)     Conduct a thorough review from families as to what
20      they identify as the real or perceived challenges with plans
21      of safe care and access to clinically appropriate substance
22      use disorder treatment and recovery services during pregnancy
23      and the postpartum period.
24          (2)     Evaluate feedback from interdisciplinary
25      professionals, including stakeholders from health care, child
26      welfare, early intervention and substance use treatment
27      professionals regarding plans of safe care and
28      recommendations for improved outcomes for infants and their
29      families.
30          (3)     Develop strategies to address the existing

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 1    duplication resulting from health care providers being
 2    required to make two distinct notifications, one to the
 3    Department of Health for infants meeting the Neonatal
 4    Abstinence Syndrome case definition and the other to the
 5    Department of Human Services for infants born affected by
 6    prenatal substance exposure, ensuring that any recommended
 7    new approach be grounded in public health toward limiting, as
 8    appropriate, contact with and referrals to the child welfare
 9    system.
10        (4)   Assess outcomes currently measured, including
11    whether infants, with or without a plan of safe care in
12    place, are being referred to and tracked as part of the
13    Commonwealth's early intervention system, participating in
14    evidence-based home visiting or family centers, receiving
15    services as outlined in the Medicaid managed care contracts
16    or discovered in other databases such as trauma registry,
17    adoption and foster care, protective services and child
18    death.
19        (5)   Provide projections of or actual costs related to
20    the identification of the infants, notification to the
21    Department of Health and the Department of Human Services
22    about the infants and creating plans of safe care for
23    infants, including any spending as part of Medicaid managed
24    care organizations.
25        (6)   Identify how policy, practice, funding priorities
26    and outcomes measured align or are in conflict across
27    interdisciplinary local and State publicly funded agencies
28    and to what degree the policy, practice or funding is
29    directed to supporting infants and families within a
30    hospital-based versus community-based setting throughout the

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 1      first year of the infant's life and mother's postpartum
 2      period.
 3          (7)   Document innovative strategies and successful
 4      information sharing and collaboration, including through
 5      memoranda of understanding.
 6          (8)   Evaluate existing or needed State-level strategies
 7      to prevent infant and young child morbidity and mortality;
 8   and be it further
 9      RESOLVED, That the advisory committee issue a report of its
10   findings to the House of Representatives no later than 18 months
11   after the adoption of this resolution.




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