1135. Infant Safety Education and Intervention

Original Date: October 31, 2014

Revised Date: August 1, 2023

Sunset Review Date: August 31, 2027

Approved by: Frank Ordway, Chief of Staff

Purpose

The purpose of this policy is to provide guidance when working with parents or guardians, families, and caregivers who have newborns and infants to reduce the risk of child abuse and neglect.

Scope

This policy applies to Department of Children, Youth, and Families (DCYF) employees.

Laws

PL 111-320 Child Abuse Prevention Treatment Act (CAPTA) Reauthorization Act of 2010

PL 114-198 Comprehensive Addiction and Recovery Act (CARA) of 2016

Policy

Newborn, Birth to One Month: Plan of Safe Care
Caseworkers must complete Plan of Safe Care DCYF 15-491 forms with families with open cases as required by CAPTA, when newborns meet at least one of the following criteria:
1. Diagnosed with neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS) by a health care provider.
2. Identified as having withdrawal symptoms, are substance-affected, or have fetal alcohol spectrum disorder resulting from prenatal drug and alcohol exposure.
3. Born to a dependent youth.
Birth through Six Months: “Period of PURPLE Crying”
1. Caseworkers must discuss with parents, guardians, and caregivers about their knowledge and understanding of “Period of PURPLE Crying” when working with families.
2. LD workers must ask parents, guardians, and caregivers if they have previously received information on the “Period of PURPLE Crying,” when investigating, licensing, or approving home studies for families accepting placements.
3. Caseworkers and LD workers must provide educational materials to parents, guardians, and caregivers who have not received the information.
Birth to One Year: Infant Safe Sleep
1. Caseworkers must:
  1. Conduct safe sleep assessments where infants primarily reside, when:
    1. Placing an infant in a new placement setting.
    2. Completing Child Protective Services’ (CPS), Family Voluntary Services’ (FVS), and Child and Family Welfare Services’ (CFWS) interventions involving infants aged birth to one year, even if the infants are not identified as an alleged victim or identified child.
  2. Assess safe sleep conditions during subsequent monthly health and safety visits.
2. LD workers must complete the following when licensing or approving home studies with families accepting placements for infants:
  1. Assess sleeping environments.
  2. Educate families on safe sleep practices.
3. CPS investigators must observe and make recommendations for safe sleep environments for infants in licensed and unlicensed placements during an investigation.

Procedures

Newborn, Birth to One Month: Plan of Safe Care
1. Caseworkers must:
  1. Assess newborns, parents or guardians, and caregivers for needs and services.
  2. Complete the Plan of Safe Care DCYF 15-491 form with families within 10 calendar days of DCYF being made aware a newborn meets the criteria in Policy Section 1.
  3. Upload a copy or photo of the completed Plan of Safe Care DCYF 15-491 form into FamLink within 10 calendar days from either the date the:
    1. Intake was received.
    2. Newborn of a dependent youth was born.
  4. After the plan is created:
    1. Refer to services and resources identified.
    2. Review and provide a copy of the plan to both the:
      1. Parents or guardians
      2. Caregivers
    3. Obtain a signed Consent DCYF 14-012 form from each parent or guardian to share information with other providers working with them, including, but not limited to their:
      1. Substance use disorder treatment providers.
      2. Medication-Assisted Treatment (MAT) providers.
      3. Home visitors, e.g., public health nurses or Parent-Child Assistance Program (PCAP) case managers.
      4. Health care providers.
      5. Early Support for Infants and Toddlers (ESIT) providers.
2. LD workers must:
  1. Assess newborns, parents or guardians, and caregivers for needs and services.
  2. Make recommendations and provide them to caseworkers, if applicable.
3. Caseworkers must:
  1. Follow up on recommendations received from LD workers.
  2. Complete the:
    1. Service referrals.
    2. Plan of Safe Care DCYF 15-491 form, when required.
  3. Monitor the:
    1. Case.
    2. Plan of Safe Care DCYF 15-491, if applicable.
Birth through Six Months: “Period of PURPLE Crying”
1. Caseworkers and LD workers must:
  1. Determine if the parents, guardians, and caregivers received the “Period of PURPLE Crying” educational DVD or web application. If:
    1. Received, discuss any questions the parents, guardians, or caregivers may have regarding the “Period of PURPLE Crying”.
    2. Not received:
      1. Provide the “Period of PURPLE Crying” educational DVD or web application and, when available, the supplemental booklet.
      2. Review and discuss the information outlined in the booklet. The following key points must be discussed with the parents or guardians, and caregivers:
        The acronym “PURPLE” is used to describe specific characteristics of an infant’s crying and what they are experiencing is normal and a phase in their infant’s development.
        Their frustration due to “Period of Purple Crying” may cause them to shake or harm the infant, which can result in significant, if not life-threatening effects.
        Reinforce with them, that if an infant is crying and they become frustrated they should put the infant down in a safe environment to prevent harm to the infant.
  2. Play the 10 minute “PURPLE” video for the parents or guardians and caregivers after presenting the booklet, and:
    1. Emphasize the importance of the material presented.
    2. Reinforce to them that everyone caring for their infant should review the information.
    3. Remind them that the 17-minute soothing film on the DVD or web application is available to help them understand ways to soothe their infant and cope with inconsolable crying periods.
Documenting “Period of PURPLE Crying”
1. Caseworkers and LD CPS investigators must document the following in a FamLink case note:
  1. The discussion that took place with the parents or guardians and caregivers about the “Period of Purple Crying”.
  2. When the parents or guardians and caregivers received the “Period of PUPRLE Crying” educational DVD or web application and when a supplemental booklet was provided.
  3. If the parents or guardians and caregivers either:
    1. Indicated they understood the material.
    2. Refused to discuss the “Period of PURPLE Crying” materials.
2. LD workers must document the discussion that took place with the parents or guardians and caregivers in the licensing provider portal.
Birth to One Year: Infant Safe Sleep
1. Caseworkers and LD workers must:
  1. Complete a safe sleep assessment by assessing the infant’s sleeping environment using the National Institute for Health: What Does a Safe Sleep Environment Look Like?, with the parents or guardians, and caregivers of infants younger than one year, during the first face-to-face meeting.
  2. Collaborate with the parents or guardians, and caregivers to create a safe sleep environment. If one does not exist:
    1. Determine whether they have the equipment to create a safe sleep environment appropriate for the infant’s height and weight.
    2. Identify and discuss appropriate safe sleep options with them if they don’t have safe sleep equipment. These options must meet the National and Consumer Product Safety Commission standards and follow the manufacturer’s recommendations for the infant’s height and weight. Safe sleep options include, but are not limited to:
      1. Cribs
      2. Portable cribs
      3. Bassinets
      4. Flat mattresses and fitted sheets
  3. Determine in collaboration with their supervisor the response needed to meet the infant’s needs when either occurs:
    1. Parents, guardians, or caregivers decline to participate in the process of creating a safe sleep environment.
    2. There are additional risk factors, e.g., substance use or abuse, or mental health issues associated with the parents’, guardians’, or caregivers’ ability to maintain infant safety and a safe sleep environment.
2. Caseworkers must purchase a safe sleep option in collaboration with the parents or caregivers using one of the following:
  1. Providing them with a local store voucher to purchase one of the safe sleep options.
  2. Ordering the safe sleep option using following the Amazon E-Voucher DCYF document. If they want the items delivered directly to their home, obtain a signed Consent DCYF 14-012 form allowing DCYF to release their address to Amazon.
  3. Using an office credit card when the safe sleep option is needed immediately.
3. LD workers must purchase a safe sleep option in collaboration with the caregivers by:
  1. Ordering the safe sleep option using Amazon. If they want the items delivered directly to their home, obtain a signed Authorization and Consent to Share Records DCYF 15-824 form allowing DCYF to release their address to Amazon.
  2. Following the Concrete Goods policy.
4. Caseworkers and LD workers must verify the safe sleep equipment is installed and safe sleep guidelines are being followed once the equipment is received by the parents, guardians, or caregivers.
5. Caseworkers must notify LD SAM licensors or LD regional licensors immediately of concerns or risk factors identified in licensed foster homes or facilities.
6. LD workers must:
  1. Notify caseworkers and CW supervisors of concerns or risk factors found when completing home studies or foster care licenses, and conducting investigations.
  2. Not approve home studies without safe sleep environments.
  3. Assess and mitigate concerns or risk factors when notified by caseworkers in licensed homes or facilities.
Documenting the Infant Safe Sleep Assessment
1. Caseworkers must document the following into FamLink case notes:
  1. Results of the safe sleep assessment.
  2. Safety concerns or risk factors identified in the home.
  3. If parents, guardians, or caregivers decline to create a safe sleep environment for the infant.
2. LD workers must document the following into the licensing provider portal:
  1. Results of the safe sleep assessment.
  2. If parents, guardians, or caregivers decline to participate in the process of creating a safe sleep environment for the infant.
  3. Safety concerns or risk factors identified in licensed foster homes or facilities and how those concerns were mitigated.
3. LD CPS investigators must document the following in the LD CPS Investigation Assessment DCYF 09-967 form:
  1. Results of the safe sleep assessment.
  2. If parents, guardians, or caregivers decline to participate in the process of creating a safe sleep environment for the infant.
  3. Safety concerns or risk factors identified in licensed foster homes or facilities and how those concerns were mitigated.
4. CW supervisors must document the decisions made to meet infants’ needs in FamLink case notes when parents, guardians, or caregivers:
  1. Decline to participate in the process of creating safe sleep environments.
  2. There are additional risk factors.