Plans of Safe Care
Plan of Safe Care (POSC) is a federal law component of the Child Abuse Prevention and Treatment Act (CAPTA) and the Comprehensive Addiction and Recovery Act (CARA) that aims to improve the safety and well-being of infants and their families affected by prenatal substance exposure. The overarching CAPTA legislation was originally enacted in 1974, to provide federal funding and guidelines to states for the prevention, assessment, investigation, prosecution, and treatment of child abuse and neglect. The Keeping Children and Families Safe Act of 2003 expanded the CAPTA legislation and began the requirement of Plans of Safe Care. The CAPTA Reauthorization Act of 2010 made further revisions to the legislation and specifically required the identification of infants affected by Fetal Alcohol Spectrum Disorder (FASD) and Plans of Safe Care be developed for infants affected by FASD.
CAPTA is the federal law that gives DFCS the authority to investigate these cases. CAPTA legislation requires health care providers notify child protective services of all infants born and identified as affected by substance abuse, withdrawal symptoms resulting from prenatal drug exposure, or a Fetal Alcohol Spectrum Disorder, but it is ultimately the responsibility of DFCS to assess level of risk and determine whether the circumstance constitutes child abuse or neglect under state law.
The Comprehensive Addiction and Recover Act (CARA) was enacted in 2016. This federal law built upon the previous legislation in 2003 and 2010 to provide the framework for comprehensively addressing the opioid epidemic, including planning for the safe care of infants born with substance use disorders or showing withdrawal symptoms.
CARA addresses six areas that are necessary for a coordinated response: prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal. CARA legislation removed the term “illegal” when discussing substance abuse. It requires that Plans of Safe Care address the needs of both the infant and the affected family or caregiver, and every state has the authority and flexibility to determine how they implement Plans of Safe Care.
By identifying needs early, plans of safe care can provide necessary services and support with the intentions of preventing potential negative outcomes. The POSC is a documented plan designed to address the safety, health, & substance treatment needs of an affected newborn and their family affected by drug and/or alcohol exposure. This document outlines the care, support and service needs for each individual involved. In Georgia, plans are most often developed after delivery. However, the POSC can be developed with the family during the prenatal period. The POSC also identifies an individual or agency to monitor the ongoing plan (which could be a service provider, DFCS, and/or a family member). The CAPTA state grant prioritizes projects that support Plans of Safe Care (POSC) for children affected by prenatal substance exposure and their families.
Georgia considers an infant to be affected by prenatal exposure if any one of the six criteria are met:
- The infant is experiencing symptoms of withdrawal, or exhibiting harmful effects in his/her physical appearance or functioning due to exposure to substances (legal or illegal); or
- The infant has tested positive for the presence of a substance or a metabolite thereof in his/her body, blood, urine or meconium; or
- The infant has symptoms of a Fetal Alcohol Spectrum Disorder; or
- The mother testing positive for illegal substances at the birth of the infant; or
- The mother testing positive for prescription drugs due to misuse at the birth of the infant; or
- The mother self-disclosed at the birth of the infant a substance or alcohol use problem and use during pregnancy.
A Plan of Safe Care includes:
- Needs and recommended services for the prenatally exposed infant
- Needs and recommended services for the mother
- Needs and recommended services for all other children in the home
- Needs and recommended services for the father and/or other secondary caregiver(s)
See DFCS Child Welfare Policy 19.27 and 20.5 for more requirements, procedures, and practice guidance.
