Plans of Safe Care

Plans of Safe Care

Over the last two decades, the nation has experienced a four-fold increase in opioid use disorders among pregnant women and three-fold increase in rates of neonatal abstinence syndrome among infants. 1, 2 Plans of Safe Care (POSC) for infants affected by illegal substance abuse have been a requirement in child welfare legislation since 2003, but, with these increases in opioid use disorder and neonatal abstinence syndrome, the focus on planning for the safe care of infants and support for their families has intensified.

In 2016, the Comprehensive Addiction and Recovery Act modified child welfare legislation to expand POSC to include all infants affected by substance abuse withdrawals symptoms or a fetal alcohol spectrum disorder and who require services be identified for the family/caregivers of these infants. The Administration for Children, Youth and Families, Children’s Bureau, which provides guidance related to POSC, has identified multi-system collaboration as a best practice to support affected infants and their families. The following resources support tribes, regions, states, and local jurisdictions as they consider how to collaborate in planning for the safe care of infants in their communities.

  • Highlighted Resource

    • How States Serve Infants and Their Families Affected by Prenatal Substance Exposure: Brief 1 – Identification and Notification
      How States Serve Infants and Their Families Affected by Prenatal Substance Exposure: Brief 1 – Identification and Notification(PDF 2 MB)

      National Center on Substance Abuse and Child Welfare, 2021

      This series of briefs highlights states’ approaches to serving infants and their families affected by prenatal substance exposure. The briefs are derived from NCSACW’s review of states’ Annual Progress and Services Reports (APSRs) pertaining to Section 503 “Infant Plan of Safe Care” of the Child Abuse and Prevention Treatment Act (CAPTA) and years of practice-based experience providing technical assistance (TA) to support systems-level policy efforts and practice-level innovations to improve outcomes for these infants and families.

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    • How States Serve Infants and Their Families Affected by Prenatal Substance Exposure: Brief 2 – Plans of Safe Care Data and Monitoring
      How States Serve Infants and Their Families Affected by Prenatal Substance Exposure: Brief 2 – Plans of Safe Care Data and Monitoring(PDF 3.1 MB)

      National Center on Substance Abuse and Child Welfare, 2021

      This series of briefs highlights states’ approaches to serving infants and their families affected by prenatal substance exposure. The briefs are derived from NCSACW’s review of states’ Annual Progress and Services Reports (APSRs) pertaining to Section 503 “Infant Plan of Safe Care” of the Child Abuse and Prevention Treatment Act (CAPTA) and years of practice-based experience providing technical assistance (TA) to support systems-level policy efforts and practice-level innovations to improve outcomes for these infants and families.

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    • How States Serve Infants and Their Families Affected by Prenatal Substance Exposure: Brief 3 – Lessons from Implementation of Plans of Safe Care
      How States Serve Infants and Their Families Affected by Prenatal Substance Exposure: Brief 3 – Lessons from Implementation of Plans of Safe Care(PDF 3 MB)

      National Center on Substance Abuse and Child Welfare, 2021

      This series of briefs highlights states’ approaches to serving infants and their families affected by prenatal substance exposure. The briefs are derived from NCSACW’s review of states’ Annual Progress and Services Reports (APSRs) pertaining to Section 503 “Infant Plan of Safe Care” of the Child Abuse and Prevention Treatment Act (CAPTA) and years of practice-based experience providing technical assistance (TA) to support systems-level policy efforts and practice-level innovations to improve outcomes for these infants and families.

      View Document
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1 Haight, S., et al. (2018). Opioid Use Disorder Documented at Delivery Hospitalization—United States, 1999–2014. Morbidity and Mortality Weekly Report, 67, 845–849. http://dx.doi.org/10.15585/mmwr.mm6731a1

2 Ko, J.Y., Patrick, S.W., Tong, V.T., Patel, R., Lind, J.N., & Barfield, W.D. (2016). Incidence of Neonatal Abstinence Syndrome – 28 States, 1999–2013. Morbidity and Mortality Weekly Report, 65, 799–802. DOI: http://dx.doi.org/10.15585/mmwr.mm6531a2