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Kingston resident Shanelle Dates said she was floored when the medical marijuana that helped her function without a “cocktail” of prescribed drugs also put her on the radar of Luzerne County Children and Youth following the recent birth of her child.
The 25-year-old obtained a medical marijuana card in March due to several gastrointestinal conditions, anxiety and post-traumatic stress disorder. The cannabis also eliminated her need for an antidepressant, she said.
“It has been helping tremendously,” said the mother of seven, including two sets of twins.
But she said her use of medical marijuana was the sole reason she was contacted by Children and Youth as she left an area hospital following the birth of her daughter last month.
Dates said she had informed the doctor who issued the card that she was pregnant and was informed she could still remain in the program.
Continued use of medicines to treat her gastrointestinal conditions was not an option, she said, because her specialist said those drugs were unsafe for the baby.
Her obstetrics/gynaecology specialist also cleared use of the cannabis because the physical and emotional pain and instability she would experience without it could take a toll on both Dates and her unborn baby, Dates said. The OB/GYN ordered special screenings as a precaution, and Dates said no concerns were detected.
Dates said her local mental health counselor also advocated her participation in the cannabis program.
Her baby, Azariah, was born prematurely at 34 weeks on Aug. 16, but Dates said she was not alerted to any medical concerns beyond initial extra coaxing required to get the newborn to drink from a bottle.
To ensure everything was “right on the table,” Dates said she disclosed her medical marijuana usage to all medical personnel when she was admitted for delivery.
“I wasn’t hiding it. It’s not to get high. It’s for my well-being,” she said. “I took the necessary steps so that I didn’t get Children and Youth called on me.”
Refusing admission
Nearing discharge, Dates said she met with a hospital social worker who noted her use of medical marijuana marijuana while pregnant.
While exiting the hospital a short time later, a Children and Youth caseworker called her attempting to set up an immediate meeting, she said.
She put him off a day, saying she had too much to address after the hospitalization.
The baby was released the next day, and she said the caseworker appeared at her apartment while she was with her mother and the new baby picking up diapers and other newborn supplies. The babysitter watching her other children did not let him in, and he returned with a colleague later that day.
Dates said she decided she won’t let the agency in unless it obtains a court order and she can ensure witnesses are present. Insisting she is a good mother providing a safe home for her children, Dates said she is terrified inviting caseworkers into her home will open the door to permanent and intrusive reviews by the agency that she believes are unwarranted.
Her parenting is praised by Sabrina McCloe Smith, head of the nonprofit Crowd Pow Wow Proud, which provides assistance and advocacy for veterans, families and others seeking or participating in the medical marijuana program.
Smith, who is serving as an advocate for Dates, said she has received an increasing number of reports from families about medical marijuana leading to reviews by Children and Youth.
Crowd Pow Wow is planning to hold a rally in front of the county human services building on Pennsylvania Avenue in Wilkes-Barre, which houses Children and Youth, at 10 a.m. Monday to call for more awareness of concerns
Smith, who has a medical marijuana card and litany of complaints about dealings she and others have had with Children and Youth, said some eligible people have decided against seeking medical marijuana for themselves or their children.
“They’re afraid of the ball to drop, of that knock at the door,” she said.
Reporting changes
While county officials can’t divulge the reason Dates was contacted, it likely stemmed from a 2018 state law amendment that changed what cases health care providers must report.
Providers previously had to report newborns experiencing prenatal drug exposure withdrawal symptoms unless the mother, during pregnancy, was under the care of a prescribing medical professional and complying with that professional’s prescription directions.
Under the amendment, providers must report all births in which the newborns are affected by substance use or withdrawal symptoms resulting from prenatal drug exposure, as determined by the provider’s standards of professional practice.
Stemming largely from the opioid crisis, the amendment stressed provider notifications “shall not constitute a child abuse report.”
It also required providers to send their notifications to the state Department of Human Services instead of the prior practice of directing them to county agencies.
The procedure after a mandatory report also changed in the amended law.
Before, the law called for county Children and Youth to promptly perform an assessment of the child and determine whether protective services were warranted, including requirements to contact the child’s parents within 24 hours and physically see the child within 48 hours of receiving the report or immediately if there’s a question of the need for emergency protective custody.
This assessment mandate was removed from the new amended version in favor of safe care plan based on a “multidisciplinary team meeting” held prior to the child’s discharge from the health care facility.
County compliance
Although the law now requires safe care plans, county Chief Solicitor Romilda Crocamo said county Children and Youth must still perform prompt assessments as it has in the past because the state has not provided directives on changing course.
The state also has been forwarding the hospital notifications through a program that refers alleged reports of abuse and neglect, with no coding to distinguish the difference, Crocamo said. As a result, county Children and Youth must perform immediate assessments for hospital notifications as it would in response to other reports, she said.
Failure to follow up on any state referrals could constitute a deficiency when the state inspects the county agency, Crocamo said, emphasizing she cannot speak about specific cases due to confidentiality.
While awaiting a state directive, Crocamo said the county has started researching the requirements for a safe care plan. The result could be a plan in which hospitals and other providers perform an assessment without automatically bringing in Children and Youth, Crocamo said.
State agencies issued a 70-page “plan of safe care guidance” in March providing impacted entities with guidance on developing safe care plans.
Cathy Utz, deputy secretary of the state human services department’s Office of Children, Youth and Families, said the amendment “shifted the focus from the use of illegal substances by a pregnant woman to the use of any substance that affect an infant,” according to testimony she presented in March.
“With this change, we are now engaging with a much broader population of mothers and babies,” she said in the testimony, citing the inclusion of women without a substance use disorder who are using legally prescribed medications for chronic pain or other disorders.
Crocamo said she already met with one local attorney assisting Crowd Pow Wow to discuss issues involving medical marijuana and is open to further discussion.
The county must “juggle” its priority to keep children safe with requirements to respect the rights of parents and families and comply with state and federal regulations, she said.
“It’s a new area of law, and we all have to get caught up,” she said.
After hearing horror stories from other Crowd Pow Wow participants about children lost to the foster care system, Dates said she is distrustful of forced agency intervention and already has a strong support system.
“It makes me want to hug them tighter,” she said, pulling two of her children closer.
