Plans of Safe Care Infants With Prenatal Substance Exposure and Their Families - Illinois

Definitions

Citation: Comp. Stat. Ch. 325, § 5/3; Ch. 20, § 301/1-10; DCFS Pol. Guide 2001.15

The term 'neglected child' includes a newborn infant whose blood, urine, or meconium contains any amount of a controlled substance, as defined in the Illinois Controlled Substances Act, or a metabolite thereof, with the exception of a controlled substance or metabolite thereof whose presence in the newborn infant is the result of medical treatment administered to the mother or the newborn infant.

The term 'substance use disorder' means a spectrum of persistent and recurring problematic behavior that encompasses 10 separate classes of drugs: alcohol; caffeine; cannabis; hallucinogens; inhalants; opioids; sedatives, hypnotics and anxiolytics; stimulants; and tobacco; and other unknown substances leading to clinically significant impairment or distress.

In policy: The term 'controlled substances' means those substances defined in chapter 720, § 570/102(f), including such drugs as heroin, cocaine, morphine, peyote, PSD, PCP, pentazocine, and methaqualone. Marijuana, hashish, and other derivatives of the plant cannabis sativa are not controlled substances.

The term 'substance-affected infants' means infants who are born with controlled substances in their system or who have been diagnosed with fetal alcohol syndrome.

Notification/Reporting Requirements

Citation: Comp. Stat. Ch. 325, § 5/7.3b; DCFS Pol. Guide 2001.15

All persons required to report may refer to the Department of Human Services any pregnant person in this State who is addicted, as defined in the Substance Use Disorder Act.

In policy: Current DCFS policy does not require the mandatory provision of services to substance-affected infants and their families when a report is indicated; fetal alcohol syndrome or the presence of controlled substances in the blood, urine, or meconium of the infant is the only allegation present; and temporary protective custody of the substance-affected infant has not been taken. However, statistics indicate that nearly one-third of substance-affected infants will be neglected within the first year of their lives. Therefore, a more aggressive approach will be taken by the DCFS in the investigation, assessment, and provision of services to families with an indicated report involving infants who are born with fetal alcohol syndrome or controlled substances in their systems.

Assessment of the Infant and Family

Citation: Comp. Stat. Ch. 325, § 5/7.3a; DCFS Pol. Guide 2001.15

The director of the Department of Children and Family Services (DCFS) shall appoint a perinatal coordinator who shall be a physician licensed to practice medicine in all its branches with a specialty certification in pediatric care. Such coordinator, or other designated medical specialists, shall review all reports of suspected medical neglect involving newborns or infants, coordinate the evaluation of the subject of such report, and assist in necessary referrals to appropriate perinatal medical care and treatment. When the perinatal coordinator or other designated medical specialists, alone or in consultation with an infant care review committee established by a medical facility, determine that a newborn or infant child is being neglected, as defined in chapter 325, § 5/3, a designated employee of DCFS shall take the steps necessary to protect the newborn or infant child's life or health, including, but not limited to, taking temporary protective custody.

In policy: When investigators indicate reports involving substance-affected infants, they shall do the following:

• Conduct a thorough risk assessment that includes an on-site assessment of the environment in which the infant will be living and an assessment of the caregiver, other adults or children residing with the caregiver, and other persons who will be frequent visitors to the environment
• Take temporary protective custody and open a child welfare case if risk factors are present that place the child in imminent danger to the child's life or health
• Open a child welfare case even if temporary protective custody is not taken and refer the case to child welfare staff for a comprehensive assessment

Responsibility for Development of the Plan of Safe Care

Citation: Comp. Stat. Ch. 325, § 5/7.3b; DCFS Pol. Guide 2001.15

The department shall notify the local Infant Mortality Reduction Network service provider or department-funded prenatal care provider in the area in which the person resides. The service provider shall prepare a case management plan and assist the pregnant woman in obtaining counseling and treatment from a local substance use disorder treatment program licensed by the department or a licensed hospital that provides substance abuse treatment services. The local Infant Mortality Reduction Network service provider and department-funded prenatal care provider shall monitor the pregnant woman through the service program.

In policy: Child welfare staff, upon receiving referrals involving substance-affected infants, shall do the following:

• Refer the parents to a treatment agency licensed by the Department of Human Services (successor agency to the Department of Alcohol and Substance Abuse, per chapter 20, § 301/5-5) for an assessment to determine whether they have an alcohol or other drug abuse problem and need treatment
• Complete a client service plan that describes the monitoring and service activities for the family; the treatment plan for the parent and other substance-involved persons in the home; and the medical plan for the infant, even when the child has not been placed
• Provide services as dictated by the assessment and service plan

Services for the Infant

This issue is not addressed in the statutes and regulations reviewed.

Services for the Parents or Other Caregivers

Citation: Comp. Stat. Ch. 20, § 301/35-5

The Department of Human Services shall develop and maintain a comprehensive directory of service providers that provide treatment services to pregnant women, mothers, and their children in this State. The department may make the information available to recipients but may not require recipients to use specific sources of care. The department shall require that any nonresidential program receiving any funding for treatment services accept women who are pregnant, provided that such services are clinically appropriate.

The department shall create or contract with licensed, certified agencies to develop a program for the care and treatment of addicted pregnant women, addicted mothers, and their children. In implementing the programs, the department shall contract with existing residencies or recovery homes in areas having a disproportionate number of women who abuse alcohol or other drugs and need residential treatment and counseling. Priority shall be given to addicted and abusing women to whom the following apply:

• Are pregnant
• Have minor children
• Are both pregnant and have minor children
• Are referred by medical personnel because they either have given birth to a baby addicted to a controlled substance or will give birth to a baby addicted to a controlled substance

The services provided by the programs shall include, but not be limited to, the following:

• Individual medical care, including prenatal care, under the supervision of a physician
• Temporary, residential shelter for pregnant women, mothers, and children when necessary
• A range of educational or counseling services
• Comprehensive and coordinated social services, including substance abuse therapy groups for the treatment of alcoholism and other drug abuse and dependency, family therapy groups, programs to develop positive self-awareness, parent-child therapy, and residential support groups

Monitoring Plans of Safe Care

Citation: Comp. Stat. Ch. 325, § 5/7.3c; DCFS Pol. Guide 2001.15

The Department of Human Services and DCFS shall develop a community-based system of integrated child welfare and substance abuse services for the purpose of providing safety and protection for children, improving adult health and parenting outcomes, and improving family outcomes.

DCFS, in cooperation with the Department of Human Services, shall develop case management protocols for DCFS clients with substance abuse problems. The departments may establish pilot programs designed to test the most effective approaches to case management. The departments shall evaluate the effectiveness of these pilot programs and report to the governor and the general assembly on an annual basis.

In policy: If the family is unwilling to accept the services described in the plan, but will allow DCFS to monitor the family, and the worker has determined that the child is not at imminent risk of harm because of the refusal to accept the services offered, the case shall be monitored for at least 6 months. Monitoring means a minimum of twice monthly face-to-face contacts with the infant and family and verification that appropriate medical care is being provided to the child. The supervisor may determine, based on the circumstances present, that only monthly contact is required but the reasons for this decision must be documented in the plan. Intact family cases that are being monitored may be closed after 6 months if it has been verified through random urinalysis testing conducted by a drug treatment professional that the parent and other members of the household are not using controlled substances and are no longer abusing alcohol.

If the family's refusal to accept services creates imminent risk to the child's health or safety--for example, continued drug or alcohol usage by the parent or others in the household that places the child at imminent risk of harm, violent behavior, denial of access to the child for monitoring to ensure the child's safety, failure to use an apnea monitor necessary for the child's health and protection, etc.--then the worker shall immediately report the incident to the State central register, requesting that investigative staff take temporary protective custody of the child.