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

Definitions
Citation: Ann. Stat. §§ 260E.03, Subd. 15(5); 253.02, Subd. 2

The term 'neglect' includes prenatal exposure to a controlled substance, as defined in § 253B.02, subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in the child at birth, results of a toxicology test performed on the mother at delivery or the child at birth, medical effects or developmental delays during the child's first year of life that medically indicate prenatal exposure to a controlled substance, or the presence of a fetal alcohol spectrum disorder.

The term 'chemically dependent person' includes a pregnant woman who has engaged during the pregnancy in habitual or excessive use, for a nonmedical purpose, of any of the following substances or their derivatives: opium, cocaine, heroin, phencyclidine, methamphetamine, amphetamine, tetrahydrocannabinol, or alcohol.

Notification/Reporting Requirements
Citation: Ann. Stat. §§ 260E.31, Subd.1; 260E.32; 125A.27, Subd. 11

A mandated reporter shall immediately report to the local welfare agency when there is reason to believe that a woman is pregnant and has used a controlled substance for a nonmedical purpose during the pregnancy, including, but not limited to, tetrahydrocannabinol, or has consumed alcoholic beverages during the pregnancy in any way that is habitual or excessive. An oral report shall be made immediately by telephone or otherwise.

A health-care professional or a social service professional who is mandated to report is exempt from reporting if the professional is providing or collaborating with other professionals to provide the woman with prenatal care, postpartum care, or other health-care services, including care of the woman's infant. If the woman does not continue to receive regular prenatal or postpartum care after the woman's health-care professional has made attempts to contact the woman, then the professional is required.

A physician shall administer a toxicology test to a mother within 8 hours after delivery to determine whether there is evidence that she has ingested a controlled substance if the woman has obstetrical complications that are an indication of possible use of a controlled substance for a nonmedical purpose. A physician shall administer a toxicology test to each newborn infant born under the physician's care to determine whether there is evidence of prenatal exposure to a controlled substance if the physician has reason to believe, based on a medical assessment of the mother or the infant, that the mother used a controlled substance for a nonmedical purpose during the pregnancy. If the test results are positive, the physician shall report the results as neglect under § 260E.03. A negative test result does not eliminate the obligation to report under this chapter if other medical evidence of prenatal exposure to a controlled substance is present.

The term 'interagency child find systems' includes activities developed on an interagency basis with the involvement of interagency early intervention committees and other relevant community groups that use rigorous standards to actively seek out, identify, and refer infants and young children, with, or at risk of, disabilities, and their families, to reduce the need for future services. The child find system must mandate referrals for a child under age 3 who is identified as directly affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure. The referral procedures must specify that a referral must occur within 7 calendar days from the date of identification.

Assessment of the Infant and Family
Citation: Ann. Stat. § 260E.31, Subd. 2

Upon receipt of a report, the local welfare agency shall immediately conduct an appropriate assessment and offer services indicated under the circumstances.

Responsibility for Development of the Plan of Safe Care

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

Services for the Infant

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

Services for the Parents or Other Caregivers
Citation: Ann. Stat. § 260E.31, Subd. 2; § 256B.79, Subd. 4

A qualified integrated perinatal care collaborative must be able to provide the following services: 

• Provide early identification of drug and alcohol dependency and abuse during pregnancy
• Coordinate referrals and follow-up of identified patients to evidence-based or evidence-informed treatment
• Integrate perinatal care services with behavioral health and substance abuse services
• Enhance access to and effective use of needed health care or Tribal health care services, public health or Tribal public health services, social services, mental health services, chemical dependency services, or services provided by community-based providers by bridging cultural gaps within systems of care and by integrating community-based paraprofessionals such as doulas and community health workers as routinely available service components
• Encourage patient education about prenatal care, birthing, and postpartum care, including information on nutrition, reproductive life planning, breastfeeding, and parenting
• Integrate child welfare case planning with substance abuse treatment planning and monitoring, as appropriate
• Effectively systematize screening, collaborative care planning, referrals, and follow-up for behavioral and social risks known to be associated with adverse outcomes and known to be prevalent within the targeted populations
• Facilitate ongoing continuity of care to include postpartum coordination and referrals for interconception care, continued treatment for substance abuse, identification and referrals for maternal depression and other chronic mental health conditions, continued medication management for chronic diseases, and appropriate referrals to Tribal or county-based social services agencies and Tribal or county-based public health nursing services

Monitoring Plans of Safe Care
Citation: § 256B.79, Subd. 4(7); 5

A qualified integrated perinatal care collaborative must implement ongoing quality improvement activities as determined by the commissioner of the Department of Human Services, including collection and use of data from qualified providers on metrics of quality such as health outcomes and processes of care, and the use of other data that has been collected by the commissioner.

A collaborative receiving a grant under this section must identify and report any gaps in the collaborative's communication, administrative support, and direct care that need to be remedied for the collaborative to continue providing effective integrated care and enhanced services to targeted populations.