Plans of Safe Care

A Plan of Safe Care (POSC) lists and directs services and supports to ensure the safety and well-being of a substance-affected infant (SAI) and their caregivers. Plans of Safe Care differ from other safety or family service plans by including services for the infant and their substance affected caregiver(s). 

The Pennsylvania Departments of Health (DOH), Drug and Alcohol Programs (DDAP), and Human Services (DHS) have worked collaboratively with the members of the Multi-Disciplinary Workgroup on Infants with Substance Exposure (MDWISE) to develop the POSC guidance for county children and youth agencies and other county level service providers.

Statutory requirements outlined by federal 2017 Program Instruction (ACYF-CB-PI-17-02) and Pennsylvania Act 54 dictate that a POSC is initiated by a medical professional when they identify, based on standards of professional practice, an infant (up to 12 months old) born affected by prenatal substance exposure including Fetal Alcohol Spectrum Disorder (FASD).

Upon identification of an SAI, the medical professional is required to make a notification to ChildLine and to arrange for the initial POSC multi-disciplinary team (MDT) meeting. POSC go beyond the immediate safety factors of an infant by addressing their ongoing health, development, and well-being as well as the treatment and other service needs of their caregiver(s). 

Developing an individualized POSC for SAIs and caregivers requires intentional collaboration across multiple systems to ensure both the safety and well-being of the child and address the health and substance use disorder treatment needs of the family or caregiver. If at any time there is concern for the SAIs' safety, a child protective services or general protective services referral may be made to ChildLine. Such a referral will initiate additional assessment or investigation by the county children and youth agency.