NATIONAL SUMMIT
Substance Exposed Newborns: Collaborative Approaches to a Complex Issue
June 23-24, 2010
The Crowne Plaza
Old Town Alexandria, VA
This summit, hosted by the National AIA Resource Center, showcased exemplary policies and practices for identifying pregnant substance users and their newborns; referring them to child welfare, treatment and other community services; and developing plans of safe care for the newborns. Participants engaged in cross-disciplinary discussions to explore challenges, best practices, and future directions in addressing the needs of pregnant substance users and SEN.
Audio recordings, presentation slides, and handouts from this meeting are available for listening and download.
National Policy Related to SEN:
In July 2003, the federal government made an attempt at removing some of the inconsistency in state policy approaches to substance exposed newborns (SEN) through an amendment to the Child Abuse Prevention and Treatment Act (CAPTA). This amendment is intended to encourage Child Welfare Services (CWS) linkage with developmental, mental health, early intervention and health services in order to access supportive help for at-risk children. Under the new CAPTA requirement, states must have in place:
1. Policies and procedures to address the needs of infants born and identified as being affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure, including a requirement that health care providers involved in the delivery or care of such infants notify the child protective services system of the occurrence of such condition in such infants; and
2. The development of a plan of safe care for the infants born and identified as being affected by illegal substance abuse or withdrawal symptoms.
Learn how four federally funded demonstration projects have addressed these
CAPTA requirements in a new webcast, Collaborative Approaches to
Identifying and Serving Substance Exposed Newborns: Lessons Learned from
Four Demonstration Projects, taped in Berkeley, CA on September 15, 2009.
The following resources also may be helpful in developing policies and procedures to improve the prevention, identification, referral and support of substance exposed newborns.
Report of Focus Groups on Substance Exposed Newborns
During the summer and fall of 2008, the National Abandoned Infants Resource Center conducted a series of focus and discussion groups with three separate populations: child welfare administrators, pediatricians, and obstetricians. This report summarizes the findings from these sessions, which addressed issues such as the physician’s role in serving pregnant substance users and their newborns, identification of pregnant substance users and SEN, referral of SEN to child protective services, multi-disciplinary and multi-agency collaboration, and services for SEN and their families. [PDF] [Order]
The focus groups were a follow-up to a 2005 study conducted by the Resource Center and funded by the Robert Wood Johnson Foundation's Substance Abuse Policy Research Program. The study analyzed policies and practices regarding the identification, reporting and child welfare response to substance exposed newborns in eight cities throughout the United States. Data were collected through interviews with hospital nurse and social work managers, child welfare administrators, and directors of community-based family support programs in the eight cities.
Findings from this studied are documented in a report, Identifying, Reporting, and Responding to Substance Exposed Newborns: An Exploratory Study of Policies & Practices [PDF] [Order].
Other NAIARC resources on this topic include:
- Substance Exposed Newborns: Bibliography and Resources (November 2010) [PDF]
- An issue brief on Substance Exposed Infants: Noteworthy Policies & Practices (2006) [PDF] [Order]
- A literature review on Effects of Prenatal Substance Exposure on Infant and Early Childhood Outcomes (2006) [PDF] [Order]
In 2005, the Administration for Children and Families, Children’s Bureau, awarded grants to four sites to develop model policies and procedures to address the requirements of the CAPTA amendment regarding SEN.
- A Helping Hand: Mother to Mother Program, Massachusetts Department of Public Health
- Healthy Connections Program, St. Vincent Mercy Medical Center, Toledo, OH
- Colorado Systems Integration Model for Infants (C-SIMI Baby Steps), Denver Department of Human Services, Denver, CO
- Family Early Advocacy Treatment (FEAT) Program, University of Oregon in Eugene, OR
These projects have developed the following protocols and policies:
- Prenatal Screening and Brief Intervention Algorithm, (FEAT Program, 2009) [PDF]
- Standard Admission Interview for Medication Use, Substance Use & Intimate Partner Violence, (FEAT Program and Sacred Heart Medical Center, 2009) [MS Word]
- Risk Factors for Substance Exposed Newborns Checklist, (FEAT Program and Sacred Heart Medical Center, 2008) [MS Word]
- Standard Risk Assessment to Identify Substance Exposed Newborn Baby’s Algorithm, (FEAT Program, 2008) [PDF]
- Standard Risk Assessment to Identify Substance Exposed Newborn Mother’s Algorithm, (FEAT Program, 2008) [PDF]
- Community Standard for Maternal and Newborn Drug Screening, (C-SIMI Identification Work Group) [PDF]
- Collaboration Procedures for A Helping Hand: Mother to Mother (AHH Program, MA Department of Public Health, 2009) [MS Word]
- A Helping Hand: Mother to Mother Flow Chart (AHH Program, MA Department of Public Health, 2009) [MS Word]
Additional Information on State Policies and Practices related to SEN:
Even prior to the passage of the SEN-related CAPTA amendments and the federally funded demonstration projects, states had begun to address these issues from various angles. Some states have focused on the identification of and services for pregnant substance users; others have focused on the identification of substance exposed newborns; and still others have focused on service provision for substance exposed newborns. Below are links to documents providing insight into the approaches taken and policies developed in:
Arizona
Guidelines for Identifying Substance Exposed Newborns [PDF]
Substance Exposed Infants [PDF]
Missouri
Metropolitan Task Force on Drug Exposed Infants fact sheet [Word]
New Mexico
Guidelines for Obtaining Maternal and Neonatal Urine Drug Screening [Word]
Rhode Island
Rhode Island's Vulnerable Infant Program [HTML]
Virginia
Perinatal Substance Use: A Guide for Hospitals and Health Care Providers [PDF]
Washington State
Substance Abuse During Pregnancy: Guidelines for Screening [PDF]
Guidelines for Testing and Reporting Drug Exposed Newborns in Washington State [PDF]
On October 6-7, 2005, the Resource Center hosted a national conference:
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Substance
Exposed Newborns: Weaving Together Effective Policy & Practice
Audio recordings, PowerPoint slides, and other handouts
from many of the presentations from this conference
are available in our 2005
conference archive.
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The following links provide additional background information about CAPTA and related issues:
- Significant New Changes to the Federal Child Abuse Prevention and Treatment Act: Practical Implications for Child and Family Advocates (Howard Davidson, J.D., Director, ABA Center on Children and the Law, 2003) [Word]
- Prenatal Drug Exposure and Social Policy: The Search for an Appropriate Response (Steven Ondersma et al., May 2000) [PDF]
- Substance use during pregnancy: Time for policy to catch up with research (Barry Lester et al., April 2004) [PDF]
- Strategies for Addressing FASD (Project FAST, Institute for Health and Recovery, 2006) [MS Word]
For more information about issues related to CAPTA or substance exposed newborns, contact Amy Price at: amyprice@berkeley.edu or 510-643-8383.
For other NAIARC resources related to children and families affected by substance abuse, click here.
The National Center of Substance Abuse and Child Welfare also is doing work in the area of substance exposed newborns. For more information about their work, go to http://www.ncsacw.samhsa.gov or ncsacw@samhsa.gov.
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