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

Definitions
Citation: Admin. Code § 5101:2-1-01

The 'Help Me Grow' early intervention services means developmental services selected in collaboration with the parents of a child, birth through age 3, who is eligible for services under part C of the Individuals with Disabilities Education Act, and is designed to meet the developmental needs of the child and the needs of the child's family to assist appropriately in the child's development, as identified in the individualized family service plan.

'Infant' means any child from birth to 18 months of age.

'Plan of safe care' (POSC) or 'family care plan' means an arrangement that addresses the treatment needs of the substance-affected infant and the health and substance use disorder treatment needs of the affected parent, guardian, custodian, and any other caregiver residing in the home. The plan is developed with the parents or other caregivers as well as the collaborating professional partners and agencies involved in caring for the infant and family. The plan includes, but is not limited to, the following:

• Basic identifying information of the infant and caregiver(s): name, date of birth, phone number, and address
• The hospital or medical facility where the infant was delivered or transferred to, if applicable: name, address, contact person, and physician
• Medical information on the infant: treating medical personnel (doctor, specialists), current diagnosis, prescription medication, therapies, or treatment
• Health and substance use history of the parent or caregiver: diagnosis, prescribed medications, alcohol or drug treatment provider(s), behavioral health involvement, alcohol or drug treatment plan, wraparound support plan, and contact information of all providers

'Substance-affected infant' means a child under the age of 12 months who is abused due to in utero exposure to a legal or illegal substance. This does not include in-utero exposure to any substance used as prescribed during the pregnancy.

Notification/Reporting Requirements
Citation: Rev. Stat. § 2151.421

A mandated reporter who knows or has reasonable cause to suspect, based on facts that would cause a reasonable person in a similar position to suspect, that a child has suffered or faces a threat of suffering abuse or neglect shall immediately make a report to the county public children services agency (PCSA) or a peace officer in the county in which the child resides or the abuse or neglect is occurring or has occurred.

Assessment of the Infant and Family
Citation: Admin. Code § 5101:2-36-01(E), (F)

When a PCSA receives referral information on a substance-affected infant, the PCSA shall gather all information needed for a POSC.

The PCSA shall not screen out a referral if any of the following apply:

• The information needed for the POSC is not obtained.
• The POSC has not been developed.
• The POSC is not adequate to address the safety of the infant.

Responsibility for Development of the Plan of Safe Care
Citation: Admin. Code § 5101:2-36-03(S), (Z)

For all reports involving a substance-affected infant, the PCSA shall do the following:

• Ensure the POSC has been developed
• Ensure the POSC addresses the safety needs of the infant
• Ensure the POSC addresses the health and substance use disorder treatment needs of the affected family or caregiver

The final decision includes whether the case will be transferred for ongoing PCSA services, closed and referral made to community services, or closed. The following POSC participants shall be notified:

• Parents, guardians, custodians, or other caregivers for the infant
• Health-care providers involved in the delivery or care of the infant
• Collaborating professional partners and agencies that are involved in caring for the infant and family

Services for the Infant
Citation: Admin. Code § 5101:2-36-03(Z)

No later than 5 business days after completion of the assessment or investigation, the PCSA will refer any substance-affected infant to the 'Help Me Grow' early intervention services.

Services for the Parents or Other Caregivers
Citation: Rev. Code § 5103.6010; Admin. Code § 5122-40-06(R)

A residential infant care center shall do the following:

• Develop a plan of safe care in accordance with the Comprehensive Addiction and Recovery Act of 2016 (P.L. 114-198) for an infant born substance-exposed as follows:
  • Assist with the health and substance use disorder treatment needs of the infant and affected family or caregiver
  • Develop and implement a program to monitor, support, and connect affected families or caregivers through the provision of and referral to appropriate services for the infant and affected family or caregiver
• Develop and implement a program for parents and caregivers that, either individually or in a group setting, teaches parenting skills, bonding, and caring for the infant's special needs

In regulation: Each opioid treatment program (OTP) is to have written procedures for pregnant patients that include at least the following:

• A requirement that each pregnant patient admitted to the OTP be informed of the possible risks to themselves or to their unborn child from the use of medications used in medication-assisted treatment, and that abrupt withdrawal from these medications may adversely affect the unborn child
• A statement that a pregnant patient, regardless of age, who has a documented opioid use disorder and who may be in direct jeopardy of resuming illicit opioid use during pregnancy, may be placed on medication-assisted treatment
• A statement that for a pregnant patient, evidence of current physiological dependence on opioid drugs is not needed if the medical director or other authorized prescriber certifies the pregnancy, determines and documents that the person may resort to the use of opioid drugs, and determines that the use of medication-assisted treatment is justified
• A requirement that the admission of each pregnant patient to an OTP be approved by the medical director or other authorized prescriber prior to admitting the person to the program
• A requirement that OTPs develop a form for the release of information between themselves and the health-care provider providing obstetrical care
• A requirement that each pregnant patient be given education on recognizing the symptoms of neonatal abstinence syndrome near the time of delivery
• Procedures for providing prenatal care by the program or by referral to an appropriate health-care provider

Monitoring Plans of Safe Care

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