Child and Family Services Policy > Section IV - Child Protection Services > IV. C-2. Response to Infants Affected by Illegal Substance Abuse

Purpose: The Bureau has the responsibility to respond to reports from health care providers that an infant has been born that is affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure to either legal or illegal drugs regardless of whether the infant is abused or neglected. Once a report is received the Department must assure a plan of safe care for the infant.

Legal Base: Sec. 1. 22 MRSA §4004-B (See Appendix I)

Intake: Reports of drug-affected infants will be received at the centralized Child Protective Services Intake Unit and recorded in the same manner as all reports.

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All reports from health care providers alleging that an infant has been born that is affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure (legal or illegal substances) will have the report type of "drug affected baby." This type of report is selected even if there are also allegations of suspected abuse.

�	All reports of the type "drug affected baby" are appropriate and are sent to the District.

�	Intake will gather the following information from the healthcare provider making the report:

o	Which substances affected the infant?

o	What is the impact of the drugs on the infant?

§	Withdrawal

Long-term

o	Medical care the infant is now receiving

o	Medical care the infant will require in the immediate future

o	Plan of care for the infant at discharge

o	Is the mother receiving substance abuse or other services and if so who are the providers?

o	Was the mother under the influence of substances at the time of admission? At the time of birth?

�	The Intake caseworker will seek to obtain information on the following risk factors:

o	Homelessness/transience

o	No preparation by mother and/or father for the infants care and protection

o	Other children of the mother in the care of others (long term)

�	The intake caseworker will seek to obtain information about the presence of protective factors:

o	Is actively engaged in substance abuse and/or other services

o	Received prenatal care

o	Demonstrates appropriate responsiveness to the infant

o	There is evidence of a support system for the infant and mother (family, church, community based services)

o	Successfully parenting other children

�	Once the report is received and recorded the report will be sent to the appropriate District.

District Responsibilities

�	Upon receipt of a report of a drug affected baby absent allegations of abuse or neglect the unit supervisor will either (in final decision)

o	Refer it to a CIP agency

o	Refer it to Public Health Nursing

�	Upon receipt of a report of drug affected baby that includes allegations of abuse and neglect, the case will be opened as a Safety Assessment.

Cases where the infant and/or the mother has had, does have, or is likely to have medical needs should be referred to Public Health Nursing or the visiting nursing program serving the area where the family is residing.

No matter who does the fact finding the following determinations must be made.

�	That the infant was affected by or addicted to one or more substances

�	Whether the infant received appropriate medical care immediately after birth

�	That there is or is not a safe plan of care for the infant in the immediate future.

When a Safety Assessment is completed the above determinations must be made and recorded in the Decision Window.

The district will clearly communicate to the referral source the requirement to record in their records the above determinations. They will also be informed that:

If a family refuses to work with the CIP or visiting nurse agency, the agency must report that immediately to the District Office. If that occurs the report will be opened by the District and an assessment process will take place and be documented in the narrative log of the report. The assessment requires that enough information be gathered to make the above three determinations.

Sec. 1. 22 M.R.S.A. § 4004-B is enacted to read:

§ 4004-B. Infants born affected by substance abuse or after prenatal exposure to drugs.

The Department shall act to protect infants born identified as being affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure (whether or not the prenatal drug exposure was to legal or illegal drugs), regardless of whether the infant is abused or neglected. The Department shall:

A	Receive reports of infants who may be affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure;

B.	Promptly investigate all reports received of infants born who may be affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure;

C.	Determine whether each infant reported is affected by illegal substance abuse or suffers from withdrawal symptoms resulting from prenatal drug exposure;

D.	Determine whether the infant is abused or neglected and, if so, determine the degree of harm or threatened harm in each case;

For each infant whom the Department determines to be affected by illegal substance abuse or to be suffering from withdrawal symptoms resulting from prenatal drug exposure, develop, with the assistance of any health care provider involved in the mother's or the child's medical or mental health care, a plan for the safe care of the infant, and, in appropriate cases, refer the child or mother, or both, to a community organization or voluntary preventive service;

F.	For each infant whom the Department determines to be abused or neglected, comply with section 4004, subsection 2, paragraphs E and F.

Sec. 2. 22 M.R.S.A. § 4008, sub-§ 3," I and J are enacted to read:

I. Any government entity that has a need for such information in order to carry out its responsibilities under law to protect children from abuse and neglect. For purposes of this paragraph, "government entity" means a federal government entity, a state government entity of any state, and a local government entity of any state or locality, or an agent of a federal, state or local government entity; and

J. To a juvenile court when the child who is the subject of the records has been brought before the court pursuant to Title 15, Part 6 (the Maine Juvenile Code).

Sec. 3. The bold heading of 22 M.R.S.A. § 40II-A is amended to read:

§ 4011-A. Reporting of suspected abuse or neglect or prenatal exposure to drugs.

Sec. 4. 22 M.R.S.A. § 4011-A, sub-§ I-A is enacted to read:

I-A. Reporting of infants with prenatal exposure to drugs. Any health care provider involved in the delivery or care of an infant whom the provider knows or has reasonable cause to suspect has been born affected by illegal substance abuse or suffering from withdrawal symptoms resulting from prenatal drug exposure (whether or not the prenatal drug exposure was to legal or illegal drugs) shall notify the Department of that condition in the infant.

A.	The report required by this sub-section shall be made in the same manner as reports of abuse or neglect required by this subchapter.

B.	For purposes of this sub-section, "health care provider" means a person described in items (1) through (10), (15), (17) through (20), or (22) of subsection 1, or any person who assists in the delivery or birth of a child for compensation, including, but not limited to, a midwife.

C.	This subsection, and any notification made pursuant to this subsection, shall not be construed to establish a definition of what constitutes abuse or neglect.

D.	This subsection, and any notification made pursuant to this subsection, shall not be construed to require prosecution for any illegal action, including but not limited to the act of exposing a fetus to drugs or other substances.