TMA Testimony by John Isaac, MD
House Public Health Committee
HB 405 by Rep. Minjarez
March 13, 2019
On behalf of the Texas Medical Association, I would like to offer our support of House Bill 405. We applaud Representative Ina Minjarez for her efforts to bolster our state’s prevention efforts for women whose babies who may be at risk of developing Neonatal Abstinence Syndrome (NAS).
My name is John Isaac, MD, and I am a neonatologist based in San Antonio with more than 17 years of experience. Through my work in medicine, I have seen the impact of NAS on mothers and children in my practice. With a growing public focus on opioid and substance use disorders, I see exponential need for greater education, awareness, and prevention efforts for our state’s mothers and mothers-to-be, and for those who care for them.
NAS is a serious condition that results from the sudden discontinuation of fetal exposure to substances, including alcohol or illicit drugs that were used or abused by the mother during pregnancy. Although NAS is rarely fatal for newborns, it can cause complications that are more likely to require longer, medically complex initial hospitalizations. Texas has a higher NAS average hospital length of stay than national average; the average hospital length of stay in Texas is 21 days while the national average is about two weeks. Between 2010 and 2014, rates of NAS in Texas increased by 51.3 percent. Texas Medicaid pays for 54 percent of all births in the state and is thus the primary payer of hospital charges associated with NAS, underscoring the state’s critical interest in preventing and treating opioid use especially during pregnancy.
Far too many mothers and mothers-to-be are unaware of the harmful impacts alcohol and drug use can cause during pregnancy. HB 405 would make significant efforts to educate all women about the risks of developing NAS by sharing information needed to make healthy choices. As I have seen in my practice, a little education goes a long way – education about the condition, the causes, and the impacts. However, education efforts also need to go beyond prevention. HB 405 encompasses this by ensuring that women and their support network also learn about community-based resources for substance use disorder treatment.
HB 405 was written to require collaborative efforts and involve many stakeholders who are involved in the health and well-being of mothers and infants across our state. This is the best way to ensure that as many women as possible hear about NAS and its harmful outcomes. Creating more awareness of what causes NAS and potential impacts of the condition will only help our state become a better place for all mothers and babies. HB 405 would help bring needed attention and resources to help educate our state on NAS.
We appreciate the opportunity to offer support for HB 405. Thank you for your time and consideration.
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