Legislation educating 'at-risk' mothers of drug dependent babies passes committee (Johnson City Press)


Nearly one-third of babies born in Niswonger Children’s Hospital at any given time are diagnosed with neonatal abstinence syndrome, according to hospital officials.

Last year, more than 200 babies born in the Tri-Cities were exposed to addictive opiate drugs while in their mothers’ wombs.

According to a Tennessee Department of Health report, 779 total babies born in Tennessee during 2016 experienced NAS symptoms, which includes extensive trembling, irritability, high-pitched crying, seizures and hyperactive reflexes. Tennessee is ranked first in the country for the number of opioid-related births.

“In the first three months of this year, the state of Tennessee recorded 51 cases of neonatal abstinence syndrome in Northeast Tennessee and Sullivan County alone,” according to a statement from Mountain States Health Alliance. “The problem has become so prevalent in our region that Niswonger Children's Hospital is constructing a separate 16-bed unit just to care for babies experiencing symptoms related to drug exposure.”

A growing number of cases each year, the majority alarmingly clustered in the northeast section of the state, has prompted plenty of legislative reaction during the 2017-18 Tennessee General Assembly, including a bill drafted by Johnson City’s Sen. Rusty Crowe.

Titled the “Opioid Primary Prevention Act,” Crowe hopes to use TennCare as a vehicle to deliver preventive NAS educational programming to child-bearing aged mothers deemed “at risk,” meaning they have been prescribed opioids for longer than 30 days or have already delivered an opioid-affected infant.

“Current estimates show that TennCare covers birth expenses of more than 1,000 fully addicted babies and their mothers each year, while also covering an estimated 5,000-plus babies born with serious complications resulting from opioid use, such as low birth weight and pre-term births,” a press release announcing the legislation’s passage through the Senate Commerce and Labor Committee stated.

According to a press release from Crowe’s office, opioid-affected births are estimated to cost Tennessee taxpayers between $200 million and $250 million annually in hospital care through the state’s TennCare program.

That figure does not include the percentage of children impacted by opioids that end up in state custody. All told, the cost for opioid-affected children from birth to 8 years old is nearly $500 million annually, Crowe estimated.

“Those who abuse drugs are not the only persons harmed by Tennessee’s opioid epidemic,” said Sen. Crowe, who chairs the Senate Commerce and Labor Committee. “There are terrible short-term and long-term effects on infants due to the mother’s use of these drugs. This legislation calls for a targeted education effort to curb the number of babies born with this condition.”

Crowe’s legislation would educate the women on the risks of intrauterine drug exposure and contraceptive options.

If passed, TennCare would require managed care organizations to contract with a prevention service contractor to reduce the expense to the state of opioid-affected births.

Using a “Pay for Success” model means the cost would be borne by the chosen prevention service contractor, which would only be compensated for proven prevention of opioid-affected births, according to a set formula.

Crowe said the bill is a result of work done by Speaker Beth Harwell’s Opioid Abuse Task Force, of which state Rep. Matthew Hill, R-Jonesborough, was a member, and compelling testimony his committee heard earlier this year.

“This legislation is the first to come to us from the task force, put together by Speaker Harwell, to combat NAS and opioid abuse by the mothers,” Crowe said. “I was pleased to be asked to shepherd this bill through the Senate committee process; as Tennessee is No. 1 in the nation in the prevalence of neonatal abstinence syndrome babies. Hopefully we can begin to get these numbers down somewhat.”

The bill will now be heard by the Senate Finance Ways and Means Committee before going to a full Senate vote. The companion House bill will be heard by the Health Subcommittee on April 12.

Niswonger’s special NAS intensive care unit is slated to open next month, officials said. It will offer special services for families and provide an environment of care tailored to the specific needs of withdrawing infants.

Email Zach Vance at zvance@johnsoncitypress.com. Follow Zach Vance on Twitter at @ZachVanceJCP. Like him on Facebook at Facebook.com/ZachVanceJCP.