Plan of Safe Care

Purpose of a Plan of Safe Care:

  • Ensure the parent and infant remain safe and healthy
  • Work with the family to identify any needs they may have
  • Connect the family to resources in the community and follow-up over time to ensure needs are met

A Plan of Safe Care (POSC) is a family-centered prevention plan designed to promote the safety and well-being of birthing parents and their infants with prenatal substance exposure. A 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.

Due to Federal legislation changes in recent years, the population of infants requiring a POSC has expanded beyond infants exposed to illegal substances. It now includes infants experiencing prenatal substance exposure to any substance with abuse potential including some prescribed medications. While a family who falls within this new eligibility may not warrant a referral to Child Protective Services, it is important they have the support necessary to mitigate risk as they bring their baby home and keep their family together and thriving.

In September 2019, DCYF began receiving in-depth technical assistance (IDTA) through the National Center on Substance Abuse and Child Welfare (NCSACW). This work included significant stakeholder engagement in defining criteria for a POSC in Washington, developing goals, and planning for implementation. 

Partners included Washington Tribes and stakeholders such as substance use disorder providers, health care professionals, public health nurses, home visitors, early intervention providers, and local courts. System partners participating in this work represented the Department of Health, the Health Care Authority, and the Administrative Office of the Courts.

The collaborative workgroup identified a set of criteria to determine when a family must be reported to Child Protective Services. Child welfare intake screening policy was updated to align with these criteria in August 2023. Infants with specific substance exposure and no safety concerns are referred to Help Me Grow. This new referral pathway to Help Me Grow offers a community-based response to provide wrap-around services and supports to families who would traditionally be routed to Child Welfare or are currently offered no resources. Birthing hospital social workers and nurses can connect gestational parents/caregivers and their babies to these supports through an online referral.

In June 2023, DCYF, the Department of Health, the Health Care Authority, and the Washington State Hospital Association released a cross-agency letter and press release supporting implementation of the Plan of Safe Care and aligned bodies of work. Birthing hospitals have been asked to update policies and procedures by Jan. 1, 2025.

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