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New NICU Drug Prevention Pilot Program Underway

In an attempt to combat the rising number of infants requiring stays in the Neonatal Intensive Care Unit (NICU) after birth, Tennessee passed a bill in 2014 commonly referred to as the fetal assault law. Under this law, mothers could be prosecuted for the illegal use of drugs while pregnant, if the baby was born addicted to or harmed by the drugs taken by the mother. There were many opponents to this bill as most believed that this would not prevent the mother's drug use, but would simply deter her from seeking much needed prenatal care in order to avoid incarceration...and they were right.

In July 2016, this law expired because, as predicted by those opposed, it completely failed. On its heels is a pilot program initiated by the governor's children's cabinet to take a different approach to helping the helpless - those babies born with Neonatal Abstinence Syndrome or NAS due to in-utero drug exposure.

We have all seen the videos of the trembling baby born with NAS. The baby is born addicted to illegal drugs and must undergo a lengthy stay in the NICU in order to be slowly weaned from the illegal drugs, beginning his or her life with detox. Often, these children suffer a great deal of developmental delays and physical disabilities. Many do not meet crucial developmental milestones as they should and the effects of NAS are felt throughout childhood and beyond.

When a mother seeks prenatal care, she is often drug screened. If she tests positive for illegal substances at any time throughout the pregnancy, it is documented by the provider, and, once the baby is born, a report is made to the Department of Children's Services (DCS). Once DCS and the Juvenile Court get involved, the mother must prove to the Court that she is able to provide for her baby. The proof sought is generally enrollment in substance abuse treatment, enrollment in mental health treatment, earning a stable income, and maintaining appropriate housing; though the requirements may differ as based on the specific needs of the family and infant. During this time, the baby remains in foster care or in the care of relatives, forming a bond with this caregiver. The mother is allowed very few hours of visitation with the child, preventing the ability to bond with the child and vastly lowering the likelihood of reunification.

Under the State's new program, the mother enrolls in the program voluntarily and is allowed to take the baby home; allowing for the critical bond between mother and child to form. During this time, the mother is supposed to be closely monitored by a host of providers in the community. These organizations are the mother's team of support, helping her to achieve her goals in order to successfully graduate from the program. These services are funded by a state grant and are completely free to the mother. The mother is asked to complete substance abuse treatment and/or mental health treatment. The mother is held to a high standard with attending substance abuse treatment as recommended, allowing service providers in and out of the home to check in, attending team meetings, and ensuring the baby's safety. Supporters of this program assert that it prevents mothers from being separated from their newborn while receiving necessary services. Supporters also argue that this program reduces the number of children in foster care. Of course, the argument against this program is that the State is supporting a program allowing drug addicts to raise babies.

If the mother relapses or does not make efforts to successfully complete the program, the baby is removed from her care and placed in the care of foster parents or relatives. The Juvenile Court then becomes involved. It is essentially the same protocol; however, the pilot program allows the mother a second chance to get the help she needs without missing crucial bonding time with her child.

Under the program, representatives from DCS and other organizations meet every three months to gather data as to the success of the program. I am interested to see the statistics upon their release.

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