About 100 infants in New Mexico have been taken into state custody so far under a new initiative aimed at safeguarding newborns with drugs or other substances in their system.
The state also has worked to improve communication with hospitals and work out kinks in the plan, leading to better safety and treatment for vulnerable children, child welfare officials said.
“This initiative is working well and children are safer,” New Mexico Children, Youth and Families Department spokesperson Jake Thompson wrote in an email late last week.
Ninety children have been taken into state custody amid investigations into 116 families since Gov. Michelle Lujan Grisham announced the plan in early July, and 66 are currently in the state’s care, Thompson wrote. Sixteen have been taken in by relatives, and courts determined the state had insufficient evidence to keep eight in its care.
But the state had started implementing the effort earlier, taking 10 children into custody before making the strategy public.
The governor launched the initiative — which critics warned would increase harm to children by stripping them from their families — as part of legislation signed into law earlier this year. It came amid high-profile deaths of young children who were exposed to drugs. Those included the June death of a 4-month-old baby who authorities said had been co-sleeping with parents who regularly exposed him to drugs. His mother had smoked fentanyl and methamphetamine the day before he was born, officials alleged.
Before this year’s passage of Senate Bill 42, which reformed New Mexico’s laws enacting the federal Comprehensive Addiction and Recovery Act, parents of a drug-exposed newborn were often sent home with their infant after the state created a plan of safe care to connect the family with services, including behavioral health care, substance use treatment and home visitation.
But the state had no way of enforcing those care plans, and families often abandoned them.
Instead of allowing babies to stay in unsafe environments, Lujan Grisham said she aimed to keep them safe by taking them into the state’s care. Under the initiative, CYFD must seek a 72-hour hold on every drug-exposed newborn before their release from the hospital, while also petitioning the courts for state custody on the grounds that the child’s parents have committed abuse and neglect.
When the agency is not granted custody of a child, the plan requires heightened monitoring of the baby and their family, with state employees required to visit their home immediately and then at least twice per month thereafter.
“These efforts have led to more consistent monitoring and earlier intervention, which increases overall child safety,” Thompson wrote in an email.
Why not increase support?
Many people have expressed concerns about the initiative, which Lujan Grisham said was more “robust” than SB 42. They argue New Mexico already struggles to place foster children in its care and that removing babies from their biological families ultimately harms them.
Sen. Linda López, D-Albuquerque, said in an interview the state should support families, first and foremost. She acknowledged New Mexico has seen rising problems with substance use, but said the solution to that problem is not to take children into the custody of an already-beleaguered child welfare agency.
“We have issues already with finding foster homes for children currently. So where will these children be going if they are removed after the 72-hour hold, right?” Lopez said. “… Our mothers need to be given support — not having your child removed after you give birth.”
CYFD said most of the children exposed to substances who are taken into custody end up in the care of relatives.
In fact, Thompson wrote, it’s rare for a child who enters state custody through the CARA initiative to stay in a CYFD office or its receiving center. When that happens, a child spends an average of one to three hours there. Most of the time, they are waiting for families to be ready to take them in, he added.
“Most CARA infants who enter CYFD custody are placed with relatives, including grandparents and extended family that we license,” he wrote. “When a safe relative is not immediately available, infants are placed with licensed foster families.”
Hospitals’ questions resolved
Lujan Grisham’s plan got off to a rocky start this summer with the medical centers on the front lines of implementing it.
Days after the initiative was announced, the New Mexico Hospital Association sent a memo to state agencies outlining dozens of questions and concerns, many of them probing the authority and capacity of the state and medical centers to hold more newborn children.
Troy Clark, president and CEO of the association, said at the time hospitals and birthing centers were “caught by surprise” by the initiative and were seeking more clarity from the Lujan Grisham administration.
In an interview last week, he said the state and hospitals had met and resolved many of the questions, though another meeting was scheduled in coming weeks to continue ironing out details in implementing the strategy.
“When we initially talked, there was extreme concern,” Clark said. “… They resolved a number of those issues.”
The hospital association voiced several questions and concerns in the memo:
- What should centers do when parents decline drug testing or screening?
- How are hospitals to handle the influx of children staying in intensive care, given already-strained nursing and other staffing shortages?
- And since not all hospitals test children for exposure to the same substances, can the state provide guidance on standardized testing?
Parents still have the right to decline drug testing or screening in New Mexico. However, the state has encouraged providers to follow their normal practices of monitoring patients for active substance use and verbally screening patients, while also recommending they implement such screenings in every case, New Mexico Health Care Authority spokesperson Marina Piña wrote in an email.
Verbal screenings to help determine whether a child has been exposed to substances — which helps remove stigma while connecting families to the resources they need — will become mandatory July 1, Piña said.
She added hospital and birthing center staff also typically rely on their clinical judgment to assess whether a newborn may have been exposed to substances. Telltale signs include tremors or jitteriness, high-pitched or inconsolable crying, feeding or sleeping difficulties, or increased muscle tone.
Piña also noted that since early implementation of the plan, the state has not seen children staying in hospitals longer than needed because CYFD cannot find placement for them.
Thompson added there have been no instances in which the state was unable to secure a temporary hold or take a child into custody before they were released from the hospital.
And hospitals have not experienced the staffing issues they were initially concerned about, Clark said.
“We may have overestimated what their implementation of the rules were,” he said. “… Yes, there are some cases where we are holding … some babies longer than we normally would, but not in the great number that we feared that it would cause people to have to go get care elsewhere.”