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

Definitions

Citation: Rev. Stat. Tit. 22, § 4002

Effective September 19, 2019: The term 'fetal alcohol spectrum disorder' (FASD) means a condition whose effects include having facial characteristics, growth restriction, central nervous system abnormalities, or other characteristics consistent with prenatal alcohol exposure identified in a child from birth to 12 months of age.

Notification/Reporting Requirements

Citation: Rev. Stat. Tit. 22, § 4011-B; CFS Pol. Man. § IV.C-2

Effective September 19, 2019: A health-care provider involved in the delivery or care of an infant who the provider knows or has reasonable cause to suspect has been born affected by substance use; has withdrawal symptoms that require medical monitoring or care beyond standard newborn care when those symptoms have resulted from or have likely resulted from prenatal drug exposure, whether the prenatal exposure was to legal or illegal drugs; or has FASD shall notify the Department of Health and Human Services of that condition in the infant. The notification required by this subsection must be made in the same manner as reports of abuse or neglect required by this subchapter.

This section, and any notification made pursuant to this section, may not be construed to establish a definition of 'abuse' or 'neglect.'

This section, and any notification made pursuant to this section, may not be construed to require prosecution for any illegal action, including, but not limited to, the act of exposing a fetus to drugs or other substances.

In policy: The Bureau of Child and Family Services has the responsibility to respond to reports from health-care providers that an infant has been born that is affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure to either legal or illegal drugs, regardless of whether the infant is abused or neglected. Once a report is received, the department must assure a plan of safe care for the infant.

Reports of drug-affected infants will be received at the centralized child protective services (CPS) intake unit and recorded in the same manner as all reports. All reports from health-care providers alleging that an infant has been born who is affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure (legal or illegal substances) will have the report type of 'drug-affected baby.' This type of report is selected even if there are also allegations of suspected abuse.

Assessment of the Infant and Family

Citation: Rev. Stat. Tit. 22, § 4004-B; CFS Pol. Man. § IV.C-2

Effective September 19, 2019: The department shall act to protect infants born identified as being affected by substance use or withdrawal symptoms resulting from prenatal drug exposure, whether the prenatal exposure was to legal or illegal drugs, or having a fetal alcohol spectrum disorder, regardless of whether the infant is abused or neglected. The department shall do the following:

• Receive notifications of infants who may be affected by substance use, have withdrawal symptoms resulting from prenatal drug exposure, or who have FASD
• Promptly investigate notifications received of infants born who may be affected by substance use, have withdrawal symptoms resulting from prenatal drug exposure, or who have FASD, as determined to be necessary by the department, to protect the infant
• Determine whether each infant is affected by substance use, withdrawal symptoms resulting from prenatal drug exposure, or has FASD
• Determine whether the infant is abused or neglected and, if so, determine the degree of harm or threatened harm in each case
• For each infant who the department determines to be abused or neglected, comply with § 4004(2)(E)-(F)

In policy: CPS Intake will gather the following information from the health-care provider making the report:

• Which substances affected the infant
• The impact of the substances on the infant
• Medical care the infant is now receiving
• Medical care the infant will require in the immediate future
• Plan of care for the infant at discharge
• Whether the mother is receiving substance abuse or other services and who the providers are
• Whether the mother was under the influence of substances at the time of admission or at the time of birth

The Intake caseworker will seek to obtain information on the following risk factors:

• Homelessness/transience
• Level of preparation by the mother and/or father for the infant's care and protection
• Other children of the mother in the long-term care of others

The intake caseworker will seek to obtain information about the presence of the following protective factors:

• Active engagement is substance abuse and/or other services
• Receipt of prenatal care
• Demonstration of appropriate responsiveness to the infant
• Evidence of a support system for the infant and mother (family, church, community-based services)
• Successful parenting of other children

Responsibility for Development of the Plan of Safe Care

Citation: Rev. Stat. Tit. 22, § 4004-B(5)

Effective September 19, 2019: The department shall develop plan for safe care (POSC). For each infant who is determined to be affected by substance use or withdrawal symptoms resulting from prenatal drug exposure or who has an FASD, the department shall develop, with the assistance of any health-care provider involved in the caregiver's or the child's medical or mental health care, a POSC for the infant and, in appropriate cases, refer the child or caregiver or both to a social service agency, a health-care provider, or a voluntary substance use disorder prevention service.

Services for the Infant

Citation: CFS Pol. Man. § IV.C-2

Cases where the infant and/or the mother has had, does have, or is likely to have medical needs should be referred to Public Health Nursing or the visiting nursing program serving the area where the family is residing.

Services for the Parents or Other Caregivers

Citation: CFS Pol. Man. § IV.C-2

Cases where the infant and/or the mother has had, does have, or is likely to have medical needs should be referred to Public Health Nursing or the visiting nursing program serving the area where the family is residing.

Monitoring Plans of Safe Care

Citation: CFS Pol. Man. § IV.C-2

If a family refuses to work with the department or visiting nurse agency, the agency must report that fact immediately to the district office. If that occurs the report will be opened by the district office, and an assessment process will take place and be documented in the narrative log of the report.