An Act To Ensure the Safety and Well-being of Infants Affected by Substance Exposure
Maine Legislature, Session 129, LD 1816
Committee: Health and Human Services
Sponsors: McCREIGHT
Amends: 22 MRSA §4002, 22 MRSA §4004-B, 22 MRSA §4011-B

Legislative Document
No. 1816
H.P. 1293
House of Representatives, June 3, 2019
An Act To Ensure the Safety and Well-being of Infants Affected by 
Substance Exposure
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204.
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative McCREIGHT of Harpswell.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §4002, sub-§5-B, as enacted by PL 2013, c. 192, §1, is 
amended to read:
5-B.  Fetal alcohol spectrum disorder.  "Fetal alcohol spectrum disorders" disorder" 
means conditions a condition whose effects include having facial characteristics, growth 
restriction, central nervous system abnormalities or other characteristics consistent with 
prenatal alcohol exposure identified in a child from birth to 12 months of age.
Sec. 2.  22 MRSA §4004-B, as amended by PL 2017, c. 407, Pt. A, §83, is further 
amended to read:
§4004-B.  Infants born affected by substance use disorder or after prenatal exposure 
to drugs or with a fetal alcohol spectrum disorder
The department shall act to protect infants born identified as being affected by illegal 
substance use, demonstrating or withdrawal symptoms resulting from prenatal drug 
exposure, whether the prenatal exposure was to legal or illegal drugs, or having a fetal 
alcohol spectrum disorders disorder, regardless of whether the infant is abused or 
neglected.  The department shall:
1.  Receive notifications.  Receive notifications of infants who may be affected by 
illegal substance use or demonstrating withdrawal symptoms resulting from prenatal drug 
exposure or who have a fetal alcohol spectrum disorders disorder;
2.  Investigate.  Promptly investigate notifications received of infants born who may 
be affected by illegal substance use or demonstrating withdrawal symptoms resulting 
from prenatal drug exposure or who have a fetal alcohol spectrum disorders disorder as 
determined to be necessary by the department to protect the infant;
3.  Determine if infant is affected.  Determine whether each infant for whom the 
department conducts an investigation is affected by illegal substance use, demonstrates or 
withdrawal symptoms resulting from prenatal drug exposure or has a fetal alcohol 
spectrum disorders disorder;
4.  Determine if infant is abused or neglected.  Determine whether the infant for 
whom the department conducts an investigation is abused or neglected and, if so, 
determine the degree of harm or threatened harm in each case;
5.  Develop plan for safe care.  For each infant whom who the department 
determines to be affected by illegal substance use, to be demonstrating or withdrawal 
symptoms resulting from prenatal drug exposure or to have who has a fetal alcohol 
spectrum disorders disorder, develop, with the assistance of any health care provider 
involved in the mother's caregiver's or the child's medical or mental health care, a plan for 
the safe care of the infant and, in appropriate cases, refer the child or mother caregiver or 
both to a social service agency, a health care provider or a voluntary substance use 
disorder prevention service; and .  For purposes of this subsection, "health care provider" 
means a person described in section 4011-A, subsection 1, paragraph A, subparagraphs 
(1) to (10), (15), (17) to (20) or (22); and
6.  Comply with section 4004.  For each infant whom who the department 
determines to be abused or neglected, comply with section 4004, subsection 2, paragraphs 
E and F.
Sec. 3.  22 MRSA §4011-B, as amended by PL 2017, c. 407, Pt. A, §84, is further 
amended to read:
§4011-B.  Notification of prenatal exposure to drugs or having a fetal alcohol 
spectrum disorder
1.  Notification of prenatal exposure to drugs or having a fetal alcohol spectrum 
disorder.  A health care provider involved in the delivery or care of an infant who the 
provider knows or has reasonable cause to suspect has been born affected by illegal 
substance use, is demonstrating has withdrawal symptoms that require medical 
monitoring or care beyond standard newborn care when those symptoms have resulted 
from or have likely resulted from prenatal drug exposure, whether the prenatal exposure 
was to legal or illegal drugs, or has a fetal alcohol spectrum disorders disorder shall notify 
the department of that condition in the infant.  The notification required by this 
subsection must be made in the same manner as reports of abuse or neglect required by 
this subchapter.
A.  This section, and any notification made pursuant to this section, may not be 
construed to establish a definition of "abuse" or "neglect."
B.  This section, and any notification made pursuant to this section, may not be 
construed to require prosecution for any illegal action, including, but not limited to, 
the act of exposing a fetus to drugs or other substances.
2.  Definition.  For purposes of this section, "health care provider" means a person 
described in section 4011-A, subsection 1, paragraph A, subparagraphs (1) to (10), (15), 
(17) to (20) or (22) or any person who assists in the delivery or birth of a child for 
compensation, including, but not limited to, a midwife.
SUMMARY
This bill modifies reporting requirements and the Department of Health and Human 
Services' responsibility for establishment of a plan of safe care to include infants affected 
by substance use regardless of whether the mother's substance use was legal or illegal.  In 
addition, this bill clarifies provisions regarding withdrawal symptoms so that the infant is 
no longer required to demonstrate withdrawal symptoms and instead is required to be 
affected by withdrawal symptoms.  This bill also changes the requirement for the safe 
plan of care to require that service referrals be made not just for a mother but for any 
caregivers of the infant.  These changes reflect changes in the federal Child Abuse 
Prevention and Treatment Act.