Reporting Requirements

In Alabama, there is no affirmative duty to report a woman who has used alcohol during pregnancy or a child with fetal alcohol syndrome. Nevertheless, legal provisions mandate that the county department of human resources investigate a complaint or report of "physical abuse," defined to include fetal alcohol syndrome or drug withdrawal at birth (excluding Methodone withdrawal) due to the mother’s substance use or misuse. Ala. Admin. Code. R. 660-5-34-.02.

In California, a positive toxicology screen at the time of the delivery of an infant is not in and of itself a sufficient basis for reporting child abuse or neglect; however, any indication of maternal substance abuse shall lead to an assessment of the mother and child. Cal. Health & Safety § 123605. If other factors are present that indicate a risk to a child, then a report shall be made. Cal. Penal Code § 11165.13.

As of July 1, 2004, a child may be taken into temporary custody by a law enforcement officer without order of the court, "when a newborn child is identified by a physician, registered nurse, licensed practical nurse, or physician's assistant engaged in the admission, care, or treatment of patients as being affected by substance abuse or demonstrating withdrawal symptoms resulting from prenatal drug exposure." Colo. Rev. Stat. § 19-3-401.

The health care practitioner for each pregnant woman who is enrolled or eligible for certain income-based services shall be encouraged to identify as soon as possible whether such woman is at risk of a poor birth outcome due to substance abuse during the prenatal period and to refer such woman to any entity approved and licensed by the department of human services for the performance of a needs assessment.

In Illinois, health care providers, social workers, law enforcement personnel, and other listed persons may refer to the Department of Human Services any pregnant person in this State who is "addicted" as defined in the Alcoholism and Other Drug Abuse and Dependency Act. 325 Ill. Comp. Stat. 5/7.3b. Under that Act, "alcoholism" is also known as addiction to alcohol and "addict" means a person who exhibits the disease known as "addiction." 20 Ill. Comp. Stat. 301/1-10.

Following the referral, the Department of Human Services shall notify the local Infant Mortality Reduction Network service provider or Department funded prenatal care provider in the area in which the person resides. The service provider shall prepare a case management plan and assist the pregnant woman in obtaining counseling and treatment from a local substance abuse service provider licensed by the Department of Human Services or a licensed hospital which provides substance abuse treatment services. The local Infant Mortality Reduction Network service provider and Department funded prenatal care provider shall monitor the pregnant woman through the service program. 325 Ill. Comp. Stat. 5/7.3b.

As of July 1, 2016, Indiana mandates that, unless ordered by a court, no physician, physician assistant, certified direct entry midwife, or advanced practice nurse may release the results of a pregnant woman’s medical tests to a law enforcement agency. This statute includes the results of urine tests, blood tests, or verbal screening or questioning about drug or alcohol abuse. Ind. Code § 25-1-9-22.

An earlier law has been repealed. A law related to reporting requirements, effective through June 30, 2005, had mandated that a council on "chemically exposed infants and children" be created. One of the primary duties of the council included data collection with regard to the extent to which infants born in Louisiana were chemically exposed. A "chemically exposed infant or child" was an infant or child who showed evidence of exposure to or the presence of alcohol. La. Rev. Stat. Ann. §§ 46:2512, 46:2514. These laws were repealed as of July 1, 2005.

In general, all laws enacted during a regular session of the Louisiana legislature take effect on August 15th of the calendar year in which the regular session is held; however, any bill may specify an earlier or later effective date. 2007 La. Acts 396 states that its reporting provision will not become effective until the legislature appropriates sufficient funds for such purposes. APIS is unable to determine whether this condition has been met.

In Maine, as of October 9, 2013, health care providers are required to report, to the Department of Health and Human Services, infants who have symptoms resembling those of fetal alcohol spectrum disorder as well as those who exhibit withdrawal symptoms resulting from prenatal drug exposure in the same manner as reports of child abuse or neglect. 22 M.R.S.A. § 4011-B. Prior to this, as of July 30, 2004, health care providers were only required to report infants suffering from withdrawal symptoms resulting from prenatal drug exposure. Once the report is received, in addition to a determination if the infant is abused and neglected, the department is required to develop a plan for safe care with the health care provider and, if appropriate, refer the child or mother or both to a social service agency or voluntary substance abuse prevention service. 22 M.R.S.A. § 4004-B.

Effective August, 1, 2010, a health care professional or a social service professional who is providing a pregnant woman with prenatal care or other healthcare services is exempt from the mandate to report a woman's use of alcoholic beverages during pregnancy to a local welfare agency. For purposes of this exemption, “prenatal care” means the comprehensive package of medical and psychological support provided throughout the pregnancy. The reporting requirement, however, still applies to those health care or social services professionals otherwise mandated to report a woman's use of alcoholic beverages during pregnancy.

In Missouri, physicians retain discretion to refer to the Department of Health and Senior Services families in which children may have been exposed to alcohol for the coordination of services to the family. Mo. Rev. Stat. § 191.737. Prior to August 28, 2012, on the other hand, upon request from the department physicians were required to obtain test samples from their patients at time of delivery to determine the extent of use of alcohol during pregnancy. Mo. Rev. Stat. § 191.745.

In Nevada, as of October 1, 2005, a physician treating a child or a person in charge of a hospital or similar institution may hold a child for up to 24 hours if there is reasonable cause to believe that the child has been affected by prenatal illegal substance abuse or has withdrawal symptoms resulting from prenatal drug exposure. On July 1, 2017, this language was amended to include "a fetal alcohol spectrum disorder or prenatal substance abuse." In such cases, the physician or other person shall immediately notify a law enforcement agency or an agency which provides child welfare services that the physician or person is holding the child. Nev. Rev. Stat. § 432B.400. As of October 1, 2005, legal provisions provide that a child welfare agency investigating a report of abuse or neglect shall not report to the Statewide Central Registry for the Collection of Information Concerning the Abuse or Neglect of a Child any information concerning a child identified as being affected by prenatal illegal substance abuse or as having withdrawal symptoms resulting from prenatal drug exposure unless the agency determines that a person has abused or neglected the child after the child was born. On July 1, 2017, this language was amended to include "a fetal alcohol spectrum disorder or prenatal substance abuse."Nev. Rev. Stat. §§ 432.0999, 432.100, 432B.310.

In Nevada prior to October 1, 2005, there was no affirmative duty to report a woman who had used alcohol during pregnancy or a child with fetal alcohol syndrome. Nevertheless, legal provisions both before and after this date mandate that the Health Division of the Department of Human Resources develop and maintain a system for monitoring fetal alcohol syndrome that includes identifying 1) geographical areas in the State in which women are at a high risk of consuming alcohol during pregnancy, and 2) groups of persons in the State that include such women. Nev. Rev. Stat. § 442.420.

As of August 1, 2003, when the department receives a report that alleges a pregnant woman has abused alcohol, in addition to referral for chemical dependency assessment, the department or its designee, may also take appropriate action under North Dakota's Civil Commitment Procedures, chapter 25-03.1. 2003 N.D. Laws 431.

Beginning on June 3, 2005, Ohio requires the reporting of the birth of a child with fetal alcohol syndrome for Data Gathering purposes to the Birth Defects Information System. Ohio Admin. Code § 3701-57-02. Both prior to and subsequently from that date, another legal provision mandates that the Department of Alcohol and Drug Addiction Services provide a manner of determining the aggregate number of children born to women who are addicted, at the time of birth, to a drug of abuse and of children born with an addiction to or a dependency on a drug of abuse. Ohio Rev. Code Ann. § 3793.15. Yet, this latter law alone does not create an affirmative duty to report a woman who has used alcohol during pregnancy or a child with fetal alcohol syndrome.

In South Carolina, there is no affirmative duty to report a woman who has used alcohol during pregnancy or a child with fetal alcohol syndrome. Nevertheless, legal provisions mandate that information on the occurrence of fetal alcohol syndrome be collected in a central database of birth defects. 61 S.C. Code Ann. Regs. § 114.

In Texas, there is no affirmative duty to report a woman who has used alcohol during pregnancy or a child with fetal alcohol syndrome. Nevertheless, legal provisions mandate that information on the occurrence of fetal alcohol syndrome be collected in a statewide central registry of birth defects. 25 Tex. Admin. Code § 37.305.

The Child Abuse Prevention and Treatment Act (CAPTA), as amended by the Comprehensive Addiction and Recovery Act of 2016 (CARA) (PL 114-198, July 22, 2016, 130 Stat 695), requires States that seek federal funding for child abuse or neglect prevention and treatment programs to establish a law or program that includes "policies and procedures (including appropriate referrals to child protection service systems and for other appropriate services) to address the needs of infants born with and identified as being affected by substance abuse or withdrawal symptoms resulting from prenatal drug exposure, or a Fetal Alcohol Spectrum Disorder, including a requirement that health care providers involved in the delivery or care of such infants notify the child protective services system of the occurrence of such condition in such infants, except that such notification shall not be construed to-- (I) establish a definition under Federal law of what constitutes child abuse or neglect; or (II) require prosecution for any illegal action * * * ." 42 U.S.C. § 5106a(b)(2)(B)(ii). For these and other relevant provisions, please see the Federal Law page for this policy topic.