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ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
VETOED
AMENDED
substance exposure; pregnant women; neglect
Purpose
Requires the Department of Child Safety (DCS), on the receipt of communication involving substance use by a pregnant woman, to provide the caller with the Arizona Care Cost Containment System's (AHCCCS) contact information and, if possible, transfer the call to AHCCCS for referral to a provider for substance use treatment. Directs a licensed or certified health care professional to refer a pregnant woman for substance abuse services and support, with the woman's consent, to facilitate maternal and infant safety on a finding of a pregnant women using alcohol or dangerous or narcotic drugs.
Background
DCS's primary purpose is to protect children. Required DCS duties necessary to achieve that purpose include investigating reports of abuse and neglect and working cooperatively with law enforcement regarding reports that include criminal conduct allegations (A.R.S. § 8-451).
DCS must operate and maintain a centralized intake hotline to protect children by receiving communications concerning suspected abuse or neglect. If a person communicates suspected abuse or neglect to a DCS employee other than through the hotline, the employee must refer the person or communication to the hotline. If a communication provides a reason to believe a criminal offense has been committed and the communication does not meet the criteria for a DCS report, a hotline worker must immediately provide the information to the appropriate law enforcement agency. Additionally, a hotline worker must prepare a DCS report if the identity or location of a child victim, the child's family or the person suspected of abuse or neglect is known or can be reasonably ascertained and outlined criteria is met (A.R.S. § 8-455).
In determining if a child is neglected, consideration must be given to the drug or alcohol abuse of the child's parent, guardian, or custodian and the mother's use of a dangerous drug, narcotic drug or alcohol during pregnancy if the child, at birth or within a year after birth, is demonstrably adversely affected by drug or alcohol use (A.R.S. § 8-819).
After a routine newborn infant's physical assessment or following notification of a newborn infant's positive toxicology screen, a regulated health care professional who reasonably believes that the newborn infant may be affected by the presence of alcohol or dangerous or narcotic drugs must immediately report the information, or cause a report to be made to, DCS (A.R.S. § 13-3620).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires DCS, if a communication involving substance abuse by a pregnant woman is received, to provide the caller with AHCCC's contact information and, if possible, transfer the call to AHCCCS, and requires AHCCCS to refer the woman to a provider for substance use treatment.
2. Prohibits the receipt of communication involving substance use by a pregnant woman from resulting in an investigation of abuse or neglect.
3. Prohibits DHS from maintaining the receipt of communication involving substance use by a pregnant woman.
4. Requires a licensed or certified health care professional, on a finding of a pregnant woman using alcohol or a dangerous or narcotic drug and subject to mandatory reporting requirements, to refer the woman to substance use services and support to facilitate maternal and infant safety.
5. Requires a licensed or certified health care professional, on a finding or report to DCS of a pregnant woman using alcohol or a dangerous or narcotic drug, to refer the woman to substance use services and support to facilitate maternal and infant safety.
6. Adds, to the factors used in determining if a child is neglected, proof that the mother was referred for, and participated in, substance use treatment certified by a licensed health care professional and allows the mother's participation to be considered a mitigating factor in determining neglect.
7. Requires a licensed or certified health care professional who suspects the use of alcohol or a dangerous or narcotic drug through clinical indicators in the prenatal period, including maternal presentation or positive toxicology or other laboratory tests, to immediately refer the woman, with the woman's consent, to substance use services and support.
8. Prohibits the presence of prenatal clinical indictors or the woman's history of substance use or participation in substance use services and support alone to be the basis of a mandatory report of suspected neglect on the birth of the child.
9. Makes technical and conforming changes.
10. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Requires DCS, on receiving a communication involving substance abuse by a pregnant woman, to provide the caller with AHCCCS's contact information, rather than providing the information to AHCCCS.
2. Prohibits DCS from maintaining the receipt of a communication involving substance use by a pregnant woman.
3. Requires a pregnant woman's consent for a licensed healthcare professional to refer the woman to substance abuse services and support.
4. Makes technical changes.
Amendments Adopted by Committee of the Whole
1. Requires a health care professional mandated to report suspected abuse or neglect of a child that suspects a pregnant woman is using alcohol or dangerous or narcotic drugs to refer the woman for substance use services only with the woman's consent.
2. Removes the requirement that substance use services for pregnant women suspected of substance use be provided by AHCCCS.
Governor's Veto Message
The Governor indicates in her veto message that H.B. 2530 would unnecessarily expand the role of DCS in decisions and actions that should be handled between a pregnant person and medical professionals. The Governor states that she respects and share's the sponsor's and proponents' goals of expanding access to voluntary substance use treatment services for pregnant people, but that these services must be made available, affordable, and accessible. Additionally, she states that changes such as these must include building trust in and right-sizing any potential involvement of DCS through broad community conversations on policy governing mandated reporting, hotline procedures and statutory neglect, but that this legislation lacks these elements.
House Action Senate Action
HHS 2/13/23 DPA 9-0-0-0 HHS 3/21/23 DPA 4-3-0
3rd Read 2/28/23 31-28-1 3rd Read 4/12/23 17-13-0
Final Read 5/15/23 31-27-1-0-1
Vetoed by the Governor 5/19/23
Prepared by Senate Research
May 22, 2023
MG/JM/slp