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

Definitions
Citation: Pol. & Proc. Guide, App. A

In policy: The term 'substance-affected newborn' means a newborn child who has withdrawal symptoms resulting from prenatal substance exposure or demonstrates physical or behavioral signs that can be attributed to prenatal exposure to substances.

The term 'substance-exposed newborn' means a newborn child who tests positive for substance(s) at birth, the mother tests positive for substance(s) at the time of delivery, or the newborn is identified by a medical practitioner as having been prenatally exposed to substance(s).

Notification/Reporting Requirements
Citation: Rev. Code § 26.44.030

When any health-care practitioner has reasonable cause to believe that a child has suffered abuse or neglect, they shall report the incident or cause a report to be made to the proper law enforcement agency or to the Department of Children, Youth, and Families (DCYF).

Assessment of the Infant and Family
Citation: Pol. & Proc. Guide, § 1135

In policy: When the child is aged birth to 1 year, the caseworker must do the following:

• Assess newborns, parents, guardians, and caregivers for needs and services
• Complete a safe sleep assessment by assessing the infant's sleeping environment with the parents, guardians, and caregivers of infants younger than 1 year during the first face-to-face meeting.

Responsibility for Development of the Plan of Safe Care
Citation: Pol. & Proc. Guide, § 1135; DCYF Form # 15-491

Caseworkers must complete a plan of safe care (POSC) with families with open cases, as required by the Child Abuse Prevention and Treatment Act, when a newborn meets at least one of the following criteria:

• The child is diagnosed with neonatal abstinence syndrome or neonatal opioid withdrawal syndrome by a health-care provider.
• The child is identified as having withdrawal symptoms, are substance-affected, or have fetal alcohol spectrum disorder resulting from prenatal drug and alcohol exposure.

After the plan is created, the caseworker must do the following:

• Make referrals to the services and resources identified in the plan
• Review and provide a copy of the plan to the parents, guardians, and caregivers

From Form # 15-491: A POSC must be developed by the DCYF with the family and documented for all screened-in intakes that identify a newborn as affected by substance(s).

Services for the Infant
Citation: DCYF Form # 15-491

Services for the affected infant will include medical care and referral to early intervention services.

Services for the Parents or Other Caregivers
Citation: Pol. & Proc. Guide, § 1135; DCYF Form # 15-491

Caseworkers must collaborate with the parents, guardians, and caregivers to create a safe sleep environment if one does not exist by doing the following:

• Determine whether they have the equipment to create a safe sleep environment appropriate for the infant's height and weight.
• Identify and discuss appropriate safe sleep options with them if they do not have safe sleep equipment 

Safe sleep options include, but are not limited to, cribs, portable cribs, bassinets, or flat mattresses and fitted sheets. Caseworkers must purchase a safe sleep option in collaboration with the parents or caregivers if needed.

From Form # 15-491: Services for the parents may include any of the following:

• Safe housing
• Information about safe sleep
• Routine child care
• Emergency child care
• Parenting support
• Crisis planning (e.g., 'purple crying')
• Service referrals
• Referrals to resources

Monitoring Plans of Safe Care
Citation: Pol. & Proc. Guide, § 1135

Caseworkers must monitor the case and the POSC. Caseworkers also must verify that the safe sleep equipment is installed and safe sleep guidelines are being followed once the equipment is received by the parents, guardians, or caregivers.