Since the 1990s, federal legislation and state regulations have required that counties maintain 1) policies and procedures addressing the needs of infants prenatally exposed to substances, including the development of Plans of Safe Care, and 2) procedures for making referrals to child welfare agencies by healthcare providers when necessary. California state regulations are clear that substance use in and of itself should not lead to a referral to a child welfare agency unless there is an apparent child safety concern. The Plans of Safe Care is a document jointly created by a pregnant or parenting person, their family, and care providers that includes information to assist with care coordination and documents support that the family is accessing or plans to access to ensure safety and wellbeing. 

In this Stress, Trauma, and Resilience (STAR) Seminar, the Los Angeles County Office of Child Protection and Health Management Associates will summarize the LA County Plans of Safe Care process and provide participants with tools and resources to initiate Plans of Safe Care from healthcare and hospital settings. This will be done by integrating the latest research on substance use, pregnant and parenting people, and mandated reporting. Recent policy and program changes, including the Family First Prevention Services Act, the LA County Board of Supervisors’ focus on perinatal substance use, and the new Mandated Supporting Initiative, create the imperative to implement approaches to Plans of Safe Care. LA County’s overarching goal with Plans of Safe Care is to ensure that pregnant people using substances and infants with prenatal substance exposure and their caregivers are assessed for strengths and needs as far upstream as possible, and then are referred/linked to community-based services. Supporting families as far upstream as possible is critical to building and enhancing the protective factors that help them thrive and keep children and families out of the child welfare system.