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

Definitions
Citation: Ann. Stat. Tit. 10A, § 1-1-105

'Deprived child' means a child who is a child in need of special care and treatment because of the child's physical or mental condition, and the child's parents, legal guardian, or other custodian is unable or willfully fails to provide such special care and treatment. As used in this paragraph, a child in need of special care and treatment includes, but is not limited to, a child who at birth tests positive for alcohol or a controlled dangerous substance and who, pursuant to a drug or alcohol screen of the child and an assessment of the parent, is determined to be at risk of harm or threatened harm to the health or safety of a child.

'Plan of safe care' (POSC) means a plan developed for an infant with neonatal abstinence syndrome or a fetal alcohol spectrum disorder upon release from the care of a health-care provider that addresses the health and substance use treatment needs of the infant and mother or caregiver.

Notification/Reporting Requirements
Citation: Ann. Stat. Tit. 10A, § 1-2-101; Admin. Code § 340:75-3-130

Every physician, surgeon, or other health-care professional, including licensed osteopathic physicians, residents, and interns, or any other health-care professional or midwife involved in the prenatal care of expectant mothers or the delivery or care of infants shall promptly report instances in which an infant tests positive for alcohol or a controlled dangerous substance to the Department of Human Services (DHS). This shall include infants who are diagnosed with neonatal abstinence syndrome (NAS) or fetal alcohol spectrum disorder (FASD).

In regulation: An investigation is conducted when the child is diagnosed with FASD.

Assessment of the Infant and Family
Citation: Admin. Code § 340:75-3-450

When an infant is alleged to be born substance-exposed or affected, the child welfare (CW) specialist will obtain the infant's test results. Cord blood is the preferred testing method. When cord blood is not available, meconium is the preferred testing method.

The CW specialist evaluates the impact of the following:

• Substance use or abuse on the person responsible for the child's (PRFC's) health, safety, and welfare ability to provide care for the infant
• The PRFC's drug of choice and how it affects the PRFC's overall functioning, cognitive ability, and safety decisions

The PRFC who uses methamphetamines, phencyclidine (PCP), heroin, cocaine, or any combination of drugs is viewed as unable to provide minimal basic care for the infant or child.

Responsibility for Development of the Plan of Safe Care
Citation: Ann. Stat. Tit. 10A, § 1-2-102

Whenever DHS determines an infant has been diagnosed with NAS or FASD, but the referral is not accepted for investigation, DHS shall develop a POSC that addresses both the infant and affected family member or caregiver. The POSC shall address, at a minimum, the health and substance use treatment needs of the infant and affected family member or caregiver.

Services for the Infant

This issue is not addressed in the laws and policies reviewed.

Services for the Parents or Other Caregivers
Citation: Ann. Stat. Tit. 63, § 1-546.4

The Department of Mental Health and Substance Abuse Services shall do the following:

• Prohibit all substance abuse treatment services administered by or contracted for by the department from refusing to treat pregnant women if space and staff expertise are available
• Require all such programs and services to give priority to accepting pregnant women for treatment and services if space and staff expertise are available
• Assist such programs in developing and implementing treatment modalities and services appropriate for pregnant women

Monitoring Plans of Safe Care
Citation: Ann. Stat. Tit. 63, § 1-550.3

The department shall establish and maintain an up-to-date record of infants born exposed to alcohol and other harmful substances. The record shall include data necessary for surveys and scientific research and other data that is necessary and proper to further the recognition, prevention, and treatment of infants born addicted to or prenatally exposed to harmful substances. The record shall include, but not be limited to, the following information:

• The classification of the birth hospital, whether it is public or private
• Results of the toxicology report on an infant and its mother and, if positive, the type of drug or drugs involved
• The date of birth, birth weight, gestational age, and race of the infant
• The county of residence
• The date and county of the report
• Demographic information on the mother, including, but not limited to, age, race, education level, marital status, and income level; whether prenatal care was received and the type of prenatal care received; and whether the care was received was private or in a public health clinic or hospital clinic
• The type of treatment and whether the mother was referred for inpatient or outpatient care
• Whether the child was recommended for removal from the custody of the parent

The department shall compile and evaluate information received from the reports required pursuant to this section into a report to be distributed on or before January 1 of each year to the governor, the president pro tempore of the senate, the speaker of the house of representatives, and such other persons as the department deems advisable or necessary.