Plans of Safe Care (POSC)
Plans of Safe Care should be developed for families with infants who may have been substance exposed during pregnancy. Ideally the POSC should be developed during pregnancy, as POSCs promote supportive, potentially protective linkages to community resources and services for infants affected by prenatal substance exposure and their families.1
Any provider involved in the care of a pregnant person or infant affected by substance use can initiate the development of the POSC. These providers include:
- Obstetrics/gynecology (OB/GYN) and primary care doctors
- Substance use disorder treatment providers or recovery coaches
- Mental health providers
- Pediatricians
- Staff from home visiting programs
- Hospital social workers/case managers
- Faith leaders or counselors
More information on POSC and templates
*Note: Federal law requires that infants born affected by substance misuse, withdrawal, or fetal alcohol spectrum disorder (FASD) receive a Plan of Safe Care that supports their families as well.
1Deutsch SA, Donahue J, Parker T, et al. “Impact of Plans of Safe Care on Prenatally Exposed Infants.” The Journal of Pediatrics, vol. 241, February 2022, pp. 54-61.37, https://doi.org/10.1016/j.jpeds.2021.10.032.
POSC Resources for Providers
The following plenary sessions were from the 2022-2023 National Center for Substance Abuse and Child Welfare (NCSACW) Policy Academy and have helpful information that all providers working with families affected by substance use should be familiar with:
Screening, Assessing, and Treating Pregnant Women with Substance Use Disorders: Dr. Mishka Terplan discusses his research and clinical work with pregnant women facing substance use disorders (SUDs). The session explores screening for SUDs during pregnancy, engaging women in treatment, and providing patient- and family-centered postpartum care.
Newborns Exposed to Substances: Understanding Their Needs and Supporting Their Caregivers: Dr. Stephen Patrick shares information about meeting the needs of infants with prenatal substance exposure and what health care for these children should include. He also discusses Firefly, a program at Vanderbilt University Medical Center to reduce the toll the opioid crisis takes on pregnant/postpartum women and their infants.
Common Developmental Trajectories of Children with Fetal Alcohol Spectrum Disorder: Dr. Douglas White describes the effects of prenatal alcohol exposure on neurodevelopment, traces the brain-based developmental and behavioral manifestations of prenatal alcohol-related brain injury across childhood and adolescence, and highlights similarities and differences between other neurodevelopmental disorders, such as Autism and ADHD.