Create a Plan of Safe Care to Support New Parents and Their Infants

About this recommendation

A structured and consistent Plan of Safe Care can strengthen protective factors, promote healthy development, and prevent child welfare involvement or out-of-home placement through connections to parenting education, safety guidance, early intervention, and wraparound resources and services.

A Plan of Safe Care is required by federal legislation for “infants born and identified as being affected by substance abuse or withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder,” and this page includes implementation recommendations for developing them in your jurisdiction.

How to do this

• Identify your focus population. Recent legislative updates have expanded this population to infants experiencing prenatal substance exposure to any substance with abuse potential, including some prescribed medications, not only those substances that may be illegal in your jurisdiction.

• Develop talking points and materials for healthcare providers to clearly lay out criteria for a child abuse report versus a plan of safe care.

• Develop a Plan of Safe Care template. The plan must: “address the health and substance use disorder treatment needs of the affected infant and the infant's family or caregiver.”

• Collect the minimum required information for federal reporting:

  • (17) The number of infants—

    • (A) identified under subsection (b)(2)(B)(ii);

    • (B) for whom a plan of safe care was developed under subsection (b)(2)(B)(iii); and

    • (C) for whom a referral was made for appropriate services, including services for the affected family or caregiver, under subsection (b)(2)(B)(iii). (source)

• When possible, limit the data collected by the child welfare agency to only the information federally required, and direct other information to an upstream community-based provider who can assist the family with the Plan of Safe Care. You can collect disaggregated / anonymized data back from the delivering program to measure performance and opportunities for improvement.

Who's doing this

What they're doing

• Washington State has many Plan of Safe care resources, including:

  • Washington State’s Plan of Safe Care template, information on the program, and their state policy

  • Plan of Safe Care online referral portal flow (in English and Spanish).

  • A codesigned definition for infants meeting this criteria, along with experts and community members with lived experience.

  • A fact sheet for healthcare providers and Bias Check pamphlet

  • A codesigned fact sheet for parents and suggested scripts for engaging parents in the Plan of Safe Care.

• Healthcare providers in Washington use an online Plan of Safe Care tool to submit data and make a reporting decision. The portal first collects deidentified aggregate data around all instances of prenatal substance exposure and then offers screening questions that direct the provider to the child abuse hotline if required; otherwise, it will prompt the provider to gain a family’s consent to make a referral to community partner Help Me Grow. This referral, in conjunction with the wrap-around resources and supports offered through Help Me Grow, makes up the Plan of Safe Care while generating a notification to DCYF (as required per legislative data collection requirements).

• This portal helps providers consistently refer families to community-based services instead of the child abuse hotline when possible, while also meeting federal legislative data collection requirements.

• Slides describing Washington’s Plan of Safe Care