Rules committee advances substitute for SB42 to move CARA to Department of Health, require plan-of-safe-care services and reporting

Senator Trujillo and cosponsor Senator Padilla presented a Senate Rules Committee substitute for SB42 that would transition the state’s Comprehensive Addiction Recovery Act (CARA) program into the Department of Health, require a mandatory plan of safe care for substance-exposed infants and expand care coordination and reporting duties.

The substitute requires that a plan of safe care be completed prior to discharge of any substance-exposed newborn from a hospital or birthing center. It requires hospitals, birthing centers and prenatal providers use Screening, Brief Intervention and Referral to Treatment (SBIRT) at prenatal or perinatal visits and live births. The bill directs the Department of Health to ensure at least one care coordinator is available at each birthing hospital in the state to help implement plans of safe care and to provide training to hospital and prenatal staff on the SBIRT program.

Senator Trujillo described the substitute as aligning the program with public-health practice and creating CARA navigators within DOH to provide intensive case management and to link families to supports and services. The substitute clarifies that plans of safe care extend to prenatal perinatal supports and that the plan's implementation requires active outreach — including family members and home-visiting programs — to support the child's safety. The substitute also requires notification to Department of Health when a plan is implemented; DOH must then ensure care coordination and, if the plan is not followed, notify the Children, Youth and Families Department (CYFD).

Department of Health and CYFD officials testified they have been coordinating implementation planning, including weekly case review meetings with managed care organizations for Medicaid cases and strategies for cases with commercial insurance. DOH witnesses said navigators will perform outreach, home visiting, and intensive case management and will notify CYFD when there is noncompliance or concern for imminent harm.

Committee members asked how “available” care coordinators would be deployed; DOH explained MCOs typically provide a care coordinator who meets the family when a positive screen occurs, but DOH navigators will fill gaps when MCO coverage is not present. Members also asked about the universe of substances that would prompt plans of safe care; DOH listed commonly screened substances including nicotine, methamphetamine, marijuana, other opioids, alcohol, and fentanyl and agreed to provide a formal list to the committee.

Senators expressed broad support for the substitute but pressed for fiscal impact details. Senator Block moved and the committee accepted an amendment to the bill’s reporting requirement, adding that the required annual report shall include recommendations identifying gaps and needed improvements. The chair recorded a do-pass on the Senate Rules Committee substitute after no recorded opposition; the committee previously moved a do-not-pass on the underlying SB42 and advanced the substitute for further action.

Members emphasized coordination between DOH and CYFD for accountability after the handoff; both agencies said coordination and protocols are in place and that weekly reviews and immediate notification would be used when navigators identify noncompliance or imminent harm.

The substitute set an effective date of July 1, 2025. Representative Armstrong was listed in testimony as a House cosponsor and DOH staff said they were working with other bills in the session to consolidate open CARA provisions into a single comprehensive measure.