HOUSE BILL No. 1447
DIGEST OF INTRODUCED BILL
Citations Affected: IC 16-35-9; IC 31-33-11.5.
Synopsis: Maternal and newborn drug screening. Establishes a
maternal and newborn drug screening protocol to standardize testing
of: (1) maternal patients for drug use during pregnancy; and (2) drug
impaired newborns. Establishes the purposes of the drug screening
protocol. Lists factors for a physician to consider in deciding whether
to order maternal or newborn drug testing. Specifies that no single
indicator justifies maternal or newborn drug testing and that the
decision to order the testing must be based on the physician's best
medical judgment after considering the totality of the circumstances.
Requires the department of child services to do the following: (1)
Develop procedures for child abuse and neglect investigations
involving drug impaired fetuses and newborns. (2) Implement a plan
to establish response teams for drug impaired fetuses and newborns
throughout Indiana. Provides that whenever a child abuse or neglect
case involves a drug impaired fetus or newborn, the county office of
family and children shall require the mother of the fetus or newborn to
participate in a substance abuse treatment plan. Requires the response
team for drug impaired infants to meet on a regular basis to: (1) review
the status of the treatment plan and the progress of the family; and (2)
recommend changes, if any. Requires the county office of family and
children to file a child in need of services petition if the mother refuses
to voluntarily cooperate with the treatment plan.
Effective: July 1, 2011.
January 18, 2011, read first time and referred to Committee on Family, Children and
First Regular Session 117th General Assembly (2011)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type
, and deletions will appear in
this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type
. Also, the
will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type
this style type
between statutes enacted by the 2010 Regular Session of the General Assembly.
HOUSE BILL No. 1447
A BILL FOR AN ACT to amend the Indiana Code concerning
family law and juvenile law.
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 16-35-9; (11)IN1447.1.1. -->
SECTION 1. IC 16-35-9 IS ADDED TO THE INDIANA CODE AS
A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
Chapter 9. Protocol for Maternal and Newborn Drug Screening
Sec. 1. The maternal and newborn drug screening protocol is
established under this chapter to standardize testing of:
(1) maternal patients for drug use during pregnancy; and
(2) drug impaired newborns.
Sec. 2. The protocol is recommended for use in all clinical
Sec. 3. The purpose of the maternal drug screening protocol
developed under this chapter is:
(1) to provide the obstetric and pediatric community with
clinical guidelines in an effort to identify maternal patients in
need of special management to avoid:
(A) maternal medical recovery complications;
(B) pediatric postpartum complications; and
(C) other developmental and nutritional deficiencies; and
(2) to provide a consistent approach to identifying factors that
suggest the likelihood of drug abuse during pregnancy to aid
(A) the specific medical management of the newborn; and
(B) the initiation of appropriate developmental and social
follow-up of the newborn.
Sec. 4. Any of the following factors may indicate the need for
maternal drug testing:
(1) No prenatal care.
(2) Late or limited prenatal care.
(3) Suspicious maternal behavior consistent with drug usage.
(4) Unexplained placental abruption.
(5) Preterm labor of no obvious cause.
(6) Intrauterine growth retardation (IUGR) with no obvious
(7) Previous known drug or alcohol abuse.
(8) Unexplained intrauterine fetal demise.
(9) Fetal heart rate or uterine contraction pattern consistent
with a hypertonic or hypercontractile uterus.
Sec. 5. Any of the following factors may indicate the need for
newborn drug testing:
(1) Neurological symptoms such as restlessness, tremors, sleep
disorders, convulsions, irritability, hypertonicity,
hypotonicity, hyperactivity, clonus, staring episodes, or
(2) Gastrointestinal symptoms such as poor feeding, vomiting,
diarrhea, abdominal distention, or increased sucking.
(3) Autonomic symptoms such as a high pitched cry, sneezing,
nasal discharge, skin abrasions, or unexplained rapid
Sec. 6. (a) No single indicator or group of indicators necessarily
justifies ordering the maternal or newborn drug testing. The
attending physician's best medical judgment based on the totality
of the circumstances surrounding a maternal or newborn patient's
history and medical condition must be considered in determining
whether a specific case warrants the invocation of the protocol
under this chapter.
(b) The list of factors in sections 4 and 5 of this chapter is not an
all inclusive list, and other signs and symptoms may indicate the
need for maternal or newborn drug testing depending on the
specific clinical situation.
Sec. 7. If maternal or newborn drug testing is ordered, the
attending physician shall document in the medical record the
reason that the testing is ordered.
Sec. 8. The maternal or newborn testing must screen for
cocaine, lysergic acid diethylamide (LSD), heroin, amphetamines,
marijuana, and their derivatives.
Sec. 9. (a) If a pregnant woman or newborn tests positive for
drugs, the attending physician shall report the woman to the
county office of family and children for placement in a substance
abuse treatment program in accordance with IC 31-33-11.5.
(b) The physician shall take all steps necessary, including the use
of a chain of custody, to preserve any corroborating evidence
indicating possible child abuse or neglect.
SOURCE: IC 31-33-11.5; (11)IN1447.1.2. -->
SECTION 2. IC 31-33-11.5 IS ADDED TO THE INDIANA CODE
AS A NEW
CHAPTER TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]:
Chapter 11.5. Treatment Response for Drug Impaired Fetuses
Sec. 1. The department shall do the following:
(1) Develop procedures to be followed in child abuse and
neglect cases involving drug impaired fetuses and newborns.
(2) Implement a plan to establish response teams for drug
impaired fetuses and newborns throughout Indiana.
Sec. 2. Whenever child abuse or neglect is alleged involving a
case of a drug impaired fetus or newborn, the county office of
family and children may contact the response team for drug
impaired fetuses and newborns and schedule an immediate
Sec. 3. Whenever the county office of family and children
substantiates child abuse or neglect involving a drug impaired fetus
or newborn, the county office of family and children shall take
steps necessary and reasonable:
(1) to protect the health and welfare of the fetus or newborn;
(2) to effectuate substance abuse treatment for the mother and
other household members.
Sec. 4. The mother's success with the treatment plan is not
(1) the success or failure of any other household member who
may have a substance abuse problem;
(2) the absence of treatment resources in the mother's county;
(3) the mother's inability to pay for the treatment.
Sec. 5. The county office of family and children shall encourage
the mother's voluntary acceptance of necessary treatment plans
(1) the mother's abuse of controlled substances; and
(2) educational services regarding the effects of abuse of the
fetus or newborn.
Sec. 6. As part of a treatment plan under section 5 of this
chapter, the county office of family and children shall require that
the mother submit to random testing for controlled substances.
Sec. 7. The response team for drug impaired fetuses and
newborns shall meet on a regular basis to:
(1) review the status of the treatment plan;
(2) review the mother's progress; and
(3) recommend any changes, if necessary.
Sec. 8. If the mother refuses to voluntarily cooperate with the
treatment plans, the county office of family and children shall file
a child in need of services petition.