The Virginia Department of Behavioral Health and Developmental Services (DBHDS) SEI-IDTA initiative will assist the Commonwealth; 1) develop a common vision and coordinated response across state systems to serve women who use, or are "at risk" to use substances, and their families; and, 2) assess laws, policies and practices that pertain to serving these women and children and make appropriate changes to ensure that they receive needed medical screening, brief intervention and referral services to all women of child bearing age.
In 2000, Virginia enacted two laws that set forth substance use screening and reporting requirements for health care providers and hospitals. Code of Virginia (COV) 63.2-1509 mandates that providers file a report with child protective services if they suspect a newborn was exposed to illegal drugs in utero and COV 32.1-127 directs hospitals to refer identified substance using women and their newborns for needed services. The two laws were inteded to complement earlier law, COV 54.1-2403 that requires prenatal providers to screen women for substance abuse.
Subsequent legislative studies in 2000-2002 found that few women and children were identified and referred to services; that there was misinformation across systems about the laws’ expectations, 42CFR Part 2, and mandates regarding services; and that there was little collaboration or coordination between health care, child welfare and behavioral health systems. Despite numerous efforts to collaborate, and to educate providers across systems regarding the multiple needs and complexities involved in serving this population, there have been few changes. Hospital reports to Child Protective Services have not increased significantly and referrals to treatment have actually declined.
Two state reports focus on this population, difficulties with intervening, the deadly consequences, and the need to better coordinate efforts. The Virginia Department of Health Child Fatality Review Team (CFRT) recently published its study, "Sleep Related Infant Deaths in Virginia" (March 2014). The report revealed that 95% of the deaths reviewed were “probably preventable.” It identified substance use as a contributing factor and recommended that DBHDS “convene an interagency workgroup to assess Virginia’s legislation, its policies and practices, and develop a coordinated response for the Commonwealth.”
The Virginia Department of Health Maternal Mortality Review Team (MMRT) will issue a report on unintended maternal overdose, which is expected to include similar recommendations.
The SEI-IDTA will provide assistance with evaluating current efforts, developing strategies to better respond as a system to substance exposed infants, and implementing recommendations from the interagency workgroup plan.
Major Program Goals
- Goal 1: State agencies will adopt a shared vision and coordinated systems approach that includes outreach, referral, medical care, beahioral health, and child welfare treatment services.
- Goal 2: Virginia will evaluate the implementation and effectiveness of state laws that address perinatal substance use, and indetify needed updates and changes as well as strategies to improve their implementation.
- Goal 3: Virginia will develop a system of care, e.g. meidcal, home visiting, behavioral health and child welfare, which ensures that all women of childbearing age receive screening, brief intervention and referral to treatment services for behavioral health risks.
The lead agency is Virginia Department of Behavioral Health and Developmental Services. The Project Liaison and primary point of contact is Martha Kurgans, the Women’s Services Coordinator. Ms. Kurgans will lead the SEI-IDTA Core Team meetings along with the assigned Change Leaders, Linda Carpenter and Jill Gresham, from NCSACW. Ms. Kurgans will assume responsibility for communications between the SEI-IDTA Core Team and the NCSACW. Designated Core Team members will report SEI-IDTA updates to the Oversight Committee.
Key Partner Agencies
The Substance Exposed Infants In-Depth Technical Assistance program encourages effective collaboration and partnerships, which are essential to systems improvement and change. Cross-system linkages between substance abuse treatment, child welfare, early childhood and education, dependency court, and other service systems are essential to the SEI-IDTA scope of work.
Early Child Care and Education
- Virginia Department of Social Services Child Protective Services
- Virginia Department of Behavioral Health and Developmental Services
- Virginia Department of Health
- Virginia Hospital and Health Care Association
- Department of Medical Assistance