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

Definitions

Citation: Fam. Law § 5-704.2; Code of Regs. § 07.02.08.02

A 'newborn' is a child younger than 30 days old who is born or who receives care in the State. A newborn is 'substance-exposed' if the newborn displays any of the following:

• A positive toxicology screen for a controlled drug, as evidenced by any appropriate test after birth
• The effects of controlled drug use or symptoms of withdrawal resulting from prenatal controlled drug exposure, as determined by medical personnel
• The effects of a fetal alcohol spectrum disorder

In regulation: The term 'FASD' means fetal alcohol spectrum disorder, which is an umbrella term for the wide range of effects from prenatal alcohol exposure, including a broad array of physical defects and cognitive, behavioral, emotional, and adaptive functioning deficits.

'Local department' means the local Department of Social Services in the county where the mother of the substance-exposed newborn resides.

Notification/Reporting Requirements

Citation: Fam. Law § 5-704.2; Code of Regs. § 07.02.08.03

A health-care practitioner involved in the delivery or care of a substance-exposed newborn shall make an oral report to the local department as soon as possible and make a written report to the local department no later than 48 hours after the contact, examination, attention, treatment, or testing that prompted the report.

A health-care practitioner is not required to make a report under this section under the following circumstances:

• The practitioner has knowledge that the head of an institution or the designee of the head or another individual at that institution has made a report regarding the substance-exposed newborn.
• The practitioner has verified, at the time of delivery, the following:
  • The mother was using a controlled substance as currently prescribed for the mother by a licensed health-care practitioner.
  • The newborn does not display the effects of withdrawal from controlled substance exposure, as determined by medical personnel.
  • The newborn does not display the effects of FASD.
  • The newborn is not affected by substance abuse.

To the extent known, an individual who makes a report under this section shall include in the report the following information:

• The name, date of birth, and home address of the newborn
• The names and home addresses of the newborn's parents
• The nature and extent of the effects of the prenatal alcohol or drug exposure on the newborn
• The nature and extent of the impact of the prenatal alcohol or drug exposure on the mother's ability to provide proper care and attention to the newborn
• The nature and extent of the risk of harm to the newborn
• Any other information that would support a conclusion that the needs of the newborn require a prompt assessment of risk and safety, the development of a plan of safe care for the newborn, and referral of the family for appropriate services

In regulation: To the extent known, a report made pursuant to this section also shall include the following information:

• The newborn's medical condition and any current or ongoing health-care needs, including an extended hospital stay prior to discharge, specific medical procedures, medication, specialized equipment, or ongoing monitoring
• Whether and when the newborn's mother had prenatal care
• The nature and extent of the mother's current drug use
• The extent to which the mother is responsive to the newborn's needs and is involved with providing care
• The extent of any limitation of the mother's cognitive skills
• The nature and extent of any history of mental illness
• The nature and extent of the impact of the prenatal alcohol or controlled drug exposure on the mother's ability to provide proper care and attention

Assessment of the Infant and Family

Citation: Fam. Law § 5-704.2; Code of Regs. §§ 07.02.08.04; 07.02.08.05

Within 48 hours after receiving the notification, the local department shall do the following:

• See the newborn in person
• Consult with a health-care practitioner with knowledge of the newborn's condition and the effects of any prenatal alcohol or drug exposure
• Attempt to interview the newborn's mother and any other individual responsible for care of the newborn

A report made under this section does not create a presumption that a child has been or will be abused or neglected.

In regulation: Within 48 hours after receiving a report of a substance-exposed newborn, the local department shall do the following:

• See the newborn in person
• Consult with a health-care practitioner with knowledge of the newborn's condition and the effects of any prenatal alcohol or controlled drug exposure
• Attempt to interview the newborn's mother and any other individual responsible for care of the newborn

Promptly after receiving a report, the local department shall assess the safety of and risk of harm to the newborn to determine whether any further intervention is necessary. The assessment may include, but is not limited to, consideration of the following:

• Prior child protective services involvement
• The mother's prior delivery of a substance-exposed newborn
• The nature and extent of the mother's alcohol and controlled drug use and treatment history
• The mother's level of cooperation and willingness to address concerns
• The extent and availability of the newborn's family or other individuals to assist with caregiving and the provision of other support
• Evidence of preparations for the newborn's birth
• The availability of stable housing with no apparent safety or health hazards
• The nature and extent of drug use in the home

Responsibility for Development of the Plan of Safe Care

Citation: Fam. Law § 5-704.2; Code of Regs. § 07.02.08.05

Promptly after receiving a report, the local department shall assess the risk of harm to and the safety of the newborn to determine whether any further intervention is necessary. If the local department determines that further intervention is necessary, the local department shall do the following:

• Develop a plan of safe care (POSC) for the newborn
• Assess and refer the family for appropriate services, including alcohol or drug treatment
• As necessary, develop a plan to monitor the safety of the newborn and the family's participation in appropriate services

In regulation: If, after the assessment, intervention is necessary, the local department shall do the following:

• Develop a POSC for the newborn
• Refer the family for appropriate services, including alcohol or controlled drug treatment
• As necessary, develop a plan to monitor the safety of the newborn and the family's participation in appropriate services

Services for the Infant

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

Services for the Parents or Other Caregivers

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

Monitoring Plans of Safe Care

Citation: Fam. Law § 5-704.2

The department shall, as necessary, develop a plan to monitor the safety of the newborn and the family's participation in appropriate services.