In an effort to reverse an alarming trend of fentanyl overdose deaths among infants and toddlers, state Sen. Dave Cortese has introduced legislation intended to provide counties with better tools to protect the Golden State’s youngest opioid victims.
The San Jose Democrat said his legislation was inspired by ongoing reporting by the Bay Area News Group about the deaths of three Bay Area infants and toddlers, including 3-month-old baby Phoenix Castro, of San Jose, who was sent home with her drug-using father last year despite warnings from social workers.
Cortese called on the state’s Department of Public Health to release guidance, data and informational materials to counties about how to deal with fentanyl exposure among California’s youngest residents.
Although he provided no specific proposals, preferring to leave it to health experts, Cortese suggested delaying the reunification of children younger than 5 and with parents who have substance abuse issues.
“Public health is as close as we’re gonna get to a statewide agency that can actually step in and say, we’re going to take the best practices, the best criteria, the best guidelines … (and) export those across all 58 counties,” Cortese said.
Cortese’s bill, Senate Bill 908, is one of several being introduced this legislative session targeting the lethal drug that killed just over 340 children younger than 5 nationally from 1999 to 2021, including 105 who were younger than 1. The overdose death of baby Phoenix last May, and the Bay Area News Group’s investigation that followed, led to calls for an overhaul of Santa Clara County’s Department of Children and Family Services and the prosecution of her father, David Castro, on felony child endangerment charges.
Baby Kristofer Ferreyra, 1, of Fremont, died last October after ingesting a lethal dose of fentanyl while at home with his mother. Baby Winter Rayo died on Aug. 12, after ingesting a lethal dose of fentanyl. Her parents have been charged with murder.
Steve Baron, a member of the Santa Clara County Child Abuse Prevention Council, welcomed more state involvement on preventing young child fentanyl deaths. The state health department could flag important issues, he said, including instructions on using the overdose-reversing medication “Narcan on young children, including toddlers like Phoenix Castro.” Although Baron said he also hoped that state and local agencies in charge of child welfare were also included in the bill.
Some experts, however, are already flagging concerns around Cortese’s bill proposal, saying it has several key shortcomings and may not actually address the issues leading up to the fentanyl deaths of baby Phoenix and others whose tragedies have made headlines in recent months.
Dr. Jeoffry Gordon, a family physician and member of the California Critical Incidents child abuse citizen review panel, said that the state already does a decent job providing policy guidance to counties on how to handle tricky child abuse cases.
The issues in Santa Clara County leading up to baby Phoenix’s death, he says, were “dysfunctional” county policies and practices, not faulty state guidance.
“To me, the idea that something like this gets a law is putting a small band aid on a festering wound,” he said.
Assistant Professor of Medicine at UCLA, Chelsea Shover, raised caution about any proposals that automatically delay the reunification of children younger than 5 with parents suffering from substance abuse.
“What I worry about when we talk about adding state level policy is the unintended consequences of making it harder for people to seek care for fear of consequences, like having their kids removed,” Shover said. “It’s what we see in states where substance use during pregnancy is criminalized — people are less likely to seek care.”
Experts say they are generally in favor of releasing more data on child fentanyl fatalities but said there are limitations to what can ethically be disclosed. The main problem is that there are few recorded fentanyl deaths in the 0-5 age group, perhaps a dozen or fewer statewide each year. Publishing statistics documenting a small number of deaths could present privacy concerns.
Other bills have also been introduced this session that specifically take aim at the growing threat of fentanyl. State Sens. Tom Umberg, an Orange County Democrat, and Rosilicie Ochoa Bogh, a San Bernardino Republican, have re-introduced a bill, known as Alexandra’s Law, which would give convicted opioid dealers a written notice that they could be charged with homicide if one of their customers dies. That bill stalled last session.
A separate bill proposal by Assemblymember Matt Haney would create a state pilot program to test wastewater throughout California for traces of “cocaine, fentanyl, methamphetamine, xylazine, methadone, buprenorphine, and naloxone.” Knowing how much fentanyl is in the wastewater supply could help health experts pinpoint surges in fentanyl use locally.