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Plans of Safe Care

Plans of Safe CareOver 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

    • On the Ground: How States Are Addressing Plans of Safe Care for Infants with Prenatal Substance Exposure and Their Families
      On the Ground: How States Are Addressing Plans of Safe Care for Infants with Prenatal Substance Exposure and Their Families(PDF 631 KB)

      National Center on Substance Abuse and Child Welfare, 2019

      This technical assistance tool provides on-the-ground examples from states across the country that have implemented comprehensive approaches to Plans of Safe Care (POSC) for Infants with Prenatal Substance Exposure (IPSE) and their families and caregivers. These concrete examples can help states and agencies consider practice and policy systems changes to best serve these families in their own communities.

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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

Contact Us

The National Center on Substance Abuse and Child Welfare offers free technical assistance to a various of systems on making policy and practice changes to improve outcomes for families affected by substance use disorders and involvement with child welfare services. To learn more about technical assistance services or if you have a question please email NCSACW at ncsacw@cffutures.org or call toll-free at 1–866–493–2758.

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