Good morning, My name is Julie Peck, I am a Birth and Bereavement Doula and a Certified Peer Recovery Specialist from Southwest Virginia. Dear Del. Hayes, Chairwoman Tran, and Members of the Committee, I would like to share a little bit about my story and what I have seen in my work. I think that with this information the committee will see the urgency of passing HB652. As a person with 20 years of lived experience with SUD and a mother to 5 beautiful children, this subject is rather close to my heart. I can state with certainty that Medication-Assisted Treatment (MAT) was an absolute life saving measure for myself and is so for many other individuals. Especially those that may find themselves with-child and in active use. This is lifesaving for the mother and the child. Individuals should not find themselves in conflicting situations for obtaining MAT legally but often do. So many women that seek MAT during pregnancy find themselves in situation’s that cause them to have to make unthinkable decisions. I have seen many individuals over the years that have chosen to not seek medical care during pregnancy. Not because they just didn’t want to go, but for the fear of losing the life they already love so dearly, growing inside of them. Some choose to pay out of pocket at a private facility for their ultrasound to prevent them from having to go through an OB doctor for fear of being reported. And, because they know they will be unfairly treated and, in most cases, punished for their use of MAT, which is the gold standard treatment for pregnant individuals with SUD, or for using Cannabis prescribed by their provider. I have seen many new mothers have their newborn baby’s removed by CPS from their arms just after birth while still in the hospital, just for taking a medication that is prescribed by a medical professional. Others have chosen to use other alternatives, like using illicit substances to keep them from getting in trouble from MAT. Of course, this is not good for Mother or baby, it can be deadly. We shouldn’t punish mothers and families, just because the parent seeks help through treatment. We shouldn’t punish the mom who uses cannabis during pregnancy. The laws now push them in the opposite direction from what they need. I worked with a wonderful first-time mom that had been on MAT throughout pregnancy. She did everything she was supposed to do and thought this was right for herself and the baby. They reported her to CPS for just taking her medication. And then, sadly, after the birth they had used the placenta to test for drugs and stated she had substances in her system that was from before her knowing she was pregnant. They removed her baby right then and discharged mom. They wouldn’t even allow a family member to take custody of the child. Over 4 individuals tried to step up to keep the baby in the family. And even after having creditable people speak on her behalf and going to multiple doctors to retest and prove that she was not using, her baby was still not returned home. It has gotten to the point that I feel it very beneficial for our CPS workers to have body worn cameras when interacting with families in the field. I wish I had more time, because there is truly so much more that should be mentioned here and discussed further. Please remember, we do recover. I will end by saying, thank you, I truly appreciate your time, and it is my hope that HB652 will pass.

Good morning, My name is Julie Peck, I am a Birth and Bereavement Doula and a Certified Peer Recovery Specialist from Southwest Virginia. Thank you, Senator Locke, for carrying this bill. I would like to share a little bit about my story and what I have seen in my work. I think that with this information the committee will see the urgency of passing SB133. As a person with 20 years of lived experience with SUD and a mother to 5 beautiful children, this subject is rather close to my heart. I can state with certainty that Medication-Assisted Treatment (MAT) was an absolute life saving measure for myself and is so for many other individuals. Especially those that may find themselves with-child and in active use. This is lifesaving for the mother and the child. Individuals should not find themselves in conflicting situations for obtaining MAT legally but often do. So many women that seek MAT during pregnancy find themselves in situation’s that cause them to have to make unthinkable decisions. I have seen many individuals over the years that have chosen to not seek medical care during pregnancy. Not because they just didn’t want to go, but for the fear of losing the life they already love so dearly, growing inside of them. Some choose to pay out of pocket at a private facility for their ultrasound to prevent them from having to go through an OB doctor for fear of being reported. And, because they know they will be unfairly treated and, in most cases, punished for their use of MAT, which is the gold standard treatment for pregnant individuals with SUD, or for using Cannabis prescribed by their provider. I have seen many new mothers have their newborn baby’s removed by CPS from their arms just after birth while still in the hospital, just for taking a medication that is prescribed by a medical professional. Others have chosen to use other alternatives, like using illicit substances to keep them from getting in trouble from MAT. Of course, this is not good for Mother or baby, it can be deadly. We shouldn’t punish mothers and families, just because the parent seeks help through treatment. We shouldn’t punish the mom who uses cannabis during pregnancy. The laws now push them in the opposite direction from what they need. I worked with a wonderful first-time mom that had been on MAT throughout pregnancy. She did everything she was supposed to do and thought this was right for herself and the baby. They reported her to CPS for just taking her medication. And then, sadly, after the birth they had used the placenta to test for drugs and stated she had substances in her system that was from before her knowing she was pregnant. They removed her baby right then and discharged mom. They wouldn’t even allow a family member to take custody of the child. Over 4 individuals tried to step up to keep the baby in the family. And even after having creditable people speak on her behalf and going to multiple doctors to retest and prove that she was not using, her baby was still not returned home. It has gotten to the point that I feel it very beneficial for our CPS workers to have body worn cameras when interacting with families in the field. I wish I had more time, because there is truly so much more that should be mentioned here and discussed further. Please remember, we do recover. I will end by saying, thank you, I truly appreciate your time, and it is my hope that SB133 will pass.

SUPPORT. Dear Del. Hayes, Chairwoman Tran, and members of the committee, my name is Dr. Elizabeth Kielb. I’m the Director of Maternal and Infant Health at March of Dimes for Virginia and across the DMV region. I’m here today in support of House Bill 652, in collaboration with Virginia Interfaith Institute for Public Policy and other stakeholders. In my work, I have seen what happens when a parent consents to a urine screening expecting care and instead is met with fear. When clinical staff are not trained in treating parents with substance use disorder, or even those already receiving treatment such as MOUD or MAT, which are the gold standard of care, they are falsely characterized as “drug abusers.” That mischaracterization can trigger unnecessary child separation, criminal involvement, and in some cases, avoidable deaths. More importantly, it fractures trust between patients and providers. When stigma replaces medical best practice, families disengage, care is delayed, and harm increases rather than decreases. In fact, the Center for Disease Controls reports that overdose is one of the leading causes of maternal deaths, particularly in the first year after delivery- year after year. The evidence is not neutral. Punitive or CPS-first approaches to prenatal substance exposure consistently produce worse outcomes, while non-punitive, health-centered approaches produce better ones. When substance exposure alone triggers child welfare involvement, pregnant patients delay prenatal care, are less likely to disclose substance use, and are less likely to engage in evidence-based treatment, like MOUD or MAT, the two I mentioned before. Further, punitive approaches are associated with increased NICU utilization and foster care entry without improving infant safety or health outcomes. HB 652 does not remove child protection; rather makes child protection more effective by aligning statutory reporting requirements with evidence-based care. This bill removes automatic CPS suspicion based solely on substance exposure, requires documented evidence of harm or substantial risk, encourages honest disclosure and treatment engagement, reinforces Plans of Safe Care and discharge planning, and preserves CPS involvement when safety concerns are present. This is exactly how non-punitive systems achieve better outcomes: by keeping the door to care open while maintaining safety oversight.

Position: Support Dear Del. Hayes, Chairwoman Tran, and Members of the Committee, March of Dimes has been working with Virginia Interfaith Center for Public Policy and other stakeholders on this important bill. We offer the following comments in support of HB 652. *Support for HB 652 – Evidence-Based Outcomes* Perinatal Substance Use Disorder: Substance use disorder during pregnancy is a complex medical condition that intersects with maternal mental health, access to care, and social determinants of health. Virginia data and national evidence demonstrate that early prenatal care, honest disclosure, and engagement in evidence-based treatment are critical to preventing adverse maternal and infant outcomes. Policies that deter care or discourage disclosure undermine these protective factors and increase the risk of preventable adverse outcomes. Evidence on Punitive vs. Non-Punitive Approaches: The extant evidence is not neutral. A growing body of peer-reviewed research demonstrates that punitive or CPS-first approaches to prenatal substance exposure do not improve infant safety or health outcomes, but rather are associated with predictable harms, including delayed initiation of prenatal care, reduced engagement in substance use disorder treatment, and under-disclosure of substance use, which can compromise clinical care. In contrast, non-punitive, health-centered approaches, including health-led Plans of Safe Care that reserve CPS involvement for situations involving documented safety concerns, are associated with earlier initiation of prenatal care, higher treatment engagement and adherence, improved maternal–infant bonding, reduced NICU utilization and length of hospital stay, and higher rates of infants being safely discharged to parents when no safety concern exists. Child Protections and Outcomes: HB 652 does not remove child protection; rather makes child protection more effective by aligning statutory reporting requirements with evidence-based care. Specifically, HB 652: -Clarifies that prenatal substance exposure alone does not constitute a “reason to suspect” abuse or neglect. -Requires documentation of evidence of harm or substantial risk when a report is made, improving the focus and effectiveness of CPS involvement. -Encourages honest disclosure and engagement in evidence-based treatment by reducing fear-driven avoidance of care. -Reinforces Plans of Safe Care and discharge planning for substance-exposed infants. -Preserves mandatory reporting and CPS involvement when independent safety concerns are present. This approach reflects federal intent under CAPTA and aligns Virginia law with best practices that protect infants by keeping families engaged in care while maintaining appropriate safety oversight. Conclusion: HB 652 represents a practical, evidence-aligned step forward for Virginia. By removing barriers to early prenatal care and treatment engagement, while preserving child protection when safety concerns exist, this legislation supports safer outcomes for infants, stronger families, and more effective use of child welfare resources.