TABLE 1. Features of neonatal abstinence syndrome case reporting — six states,* 2018–2021^†.

State (yr)§	Reporting timeliness,¶ days	Reporting criteria: clinician diagnosis**	Case follow-up††	Estimated completeness of case capture,§§ %	Use of case reports
					To determine NAS incidence, community substance use patterns, and guide program development	To characterize mother-infant hospital discharge disposition
Arizona (2017)	Unknown¶¶	Yes	None	50–75	Yes	No
Florida (2014)	180	Yes	None	>75	Yes	No
Georgia (2017)	51	Yes: infant toxicology positive.*** transitioning to CSTE case reporting definition.†††	None	>75	Yes	No
Kentucky (2014)	66	Yes	None	>75	Yes	Yes
Tennessee (2017)	28	Yes: transitioning to CSTE case reporting definition.†††	None	>75	Yes	No
Virginia (2017)	30	Yes	None	>75	Yes	No

Abbreviations: CSTE = Council of State and Territorial Epidemiologists; NAS = neonatal abstinence syndrome.

* Arizona, Florida, Georgia, Kentucky, Tennessee, and Virginia.

^† The six states that implemented mandatory NAS reporting during 2013–2017 were invited for voluntary participation in a follow-up questionnaire and telephone interview to review NAS case reporting and surveillance from May 2018 to February 2021.

^§ Year legal NAS case reporting mandate became effective; Florida had passive NAS case reporting system from the Agency for Health Care Administration within 6 months of diagnosis.

^¶ Average number of days from the time of NAS diagnosis to case report.

** Medical provider diagnosis regardless of whether infant required or was given specific treatment.

^†† System or standard operating procedure in place for follow-up of infants with diagnosed NAS or their families once state health department has been notified of the case.

^§§ Capture of total case incidence rate via case reporting compared with hospital discharge records.

^¶¶ Timeliness is unknown because state-level resources to analyze and monitor completeness received limited NAS case reports.

*** For Georgia, infants with positive toxicology or clinician diagnosis of NAS are reported.

^††† https://cdn.ymaws.com/www.cste.org/resource/resmgr/2019ps/final/19-MCH-01_NAS_final_7.31.19.pdf