Plan of Safe Care- Infants Exposed to Prenatal Substance Use 

Purpose: The Plan of Safe Care for Infants Affected by Prenatal Substance Use (CFOP 170-8) provides guidelines for ensuring mothers, infants (under age one) and family members receive supports to prevent negative outcomes associated with an infant’s prenatal exposure to substance abuse such as controlled substances, misuse of controlled substances or alcohol. All infants and mother’s affected by prenatal substance exposure shall be referred to a home visitor program (e.g., Healthy Start, Healthy Families, etc.) or family support program (e.g., high or very high-risk assessment score) for development of a Plan of Safe Care and care coordination. 

All Infants who have been affected by substance abuse and determined to be ‘Unsafe’ and are involved with case management, judicial or non-judicial, must have a Plan of Safe Care assessment and implementation.

Important Note: A Plan of Safe Care is not the equivalent of a safety plan.  A Plan of Safe Care may identify child safety and risk issues within the family, but a safety plan is the only vehicle for implementing specific protective actions.  A Plan of Safe Care is intended to facilitate a holistic, multi-disciplinary approach to responding to the needs of the entire family.   

Child Protective Investigators: Investigators will be responsible for determining if a Plan of Safe Care is in place or has been offered. If a family has a case plan, the Case Manager will be responsible for completing the Plan of Safe Care. 

Case Manager Responsibilities:  It is the child welfare professional’s responsibility to determine if a Plan of Safe Care had previously been offered to the mother and other caregivers and, if not, re-assess the need for a plan to be implemented and monitored. Upon case transfer, the case manager will evaluate existing Self Care Plans for effectiveness, identify challenges/barriers and monitoring requirements. 

Case managers shall review the pre-birth assessments when newborns are added to the household in existing cases to ensure relevant components of a Plan of Safe Care are being addressed or have been addressed by the existing case plan.  

Case managers shall also review the Plan of Safe Care components to ensure that all identified needs for the mother and infant are met by the initial case plan.   

Plan of Safe Care Components to be assessed in FFA-Ongoing and/or Progress Updates: 

1.       Mother’s Substance Use and Mental Health Needs: substance use history, mental health history, treatment history, medication assisted treatment history and referrals for services. 

2.       Infant’s Medical Care: prenatal exposure history, hospital care (NICU), length of stay, diagnosis, other medical or developmental concerns, pediatric care and follow up, referral to early intervention and other services. 

3.       Mother’s Medical Care: prenatal care history, pregnancy history, other medical concerns, screening and education, follow-up care with OB-GYN, referral to other health care services. 

4.       Family/Caregiver History and Needs: prior involvement with child welfare, child safety or risk concerns, parent-child relationship, family history, living arrangements, current support network, current services, needed support/services. 

 The Plan of Safe Care is a mandatory ongoing assessment process for CPIs and CMs that requires integration into all Family Functioning Assessments and Progress Updates.