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

Date: August 2019

Definitions

Citation: Admin. Pol. & Proc. § 14.21

'Fetal alcohol spectrum disorders' (FASD) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical problems and problems with behavior and learning. Often a person with FASD has a mix of these problems.

'Neonatal abstinence syndrome' (NAS) is a condition in which a baby has withdrawal symptoms after being exposed to certain substances. Many times, the baby is exposed when the mother uses substances such as medications or illicit drugs during pregnancy, and after the baby is born (and separated from the mother's body), the baby goes through withdrawal because it is no longer receiving the substances.

A 'plan of safe care' (POSC) is a family permanency plan for child protective services noncustodial cases (FPPNC) that involves an infant born with and identified as being affected by substance abuse or withdrawal symptoms resulting from prenatal exposure from the use of illegal drugs or the misuse of legal drugs or chemical substances or has been diagnosed with NAS or FASD. The plan must provide for services that ensure the safety and well-being of the infant.

Notification/Reporting Requirements

Citation: Admin. Pol. & Proc. § 14.21

Referrals received for infants (birth to 12 months of age) born with and identified as being affected by substance abuse or withdrawal symptoms resulting from prenatal exposure from the use of illegal drugs, the misuse of legal drugs or chemical substances, or diagnosed with NAS or FASD will be identified as a CARA case and must have a POSC to include services that ensure the safety and well-being of infants.

Assessment of the Infant and Family

Citation: Admin. Pol. & Proc. § 14.2

A POSC is created in the context of a child and family team meeting and the worker must engage families in an on-going assessment of how their strengths and needs impact the safety, permanency, and well-being of the infant involved.

Responsibility for Development of the Plan of Safe Care

Citation: Admin. Pol. & Proc. § 14.2

The Federal Comprehensive Addiction and Recovery Act of 2016 (P.L. 114-198) states that infants born with and identified as being affected by substance abuse or withdrawal symptoms resulting from prenatal exposure from the use of illegal drugs or the misuse of legal drugs or chemical substances or has been with diagnosed with NAS or FASD must have a POSC for services that ensure the safety and well-being of the infant following the release from the care of health providers. This plan includes steps for addressing the health and substance use disorder treatment needs of the infant and affected family or caregivers.

A POSC is created if services can be identified and provided to the parent or caregiver prior to the infant's release from the hospital.

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: Admin. Pol. & Proc. § 14.2

Specific tasks listed on the POSC include observable, measurable outcomes, as well as the names of the persons responsible for the completion of each task. This is to include responsibilities of the family, the Department of Children's Services, and other community resources, including the provision of services and monitoring progress.

If the parents/caregivers cannot be located or refuse to accept the needed and recommended services, the worker shall document all efforts made to involve the parents/caregivers. If the participation of the parents/caregivers is critical to the safety and well-being of that child, court involvement may be warranted.