Plans of Safe Care in Substance-Exposed Infants: Components, Complexities, and Collaboration

Plans of Safe Care, first mentioned in US federal legislation in 2003, are intended to address the health and safety of infants and families impacted by prenatal substance exposure. However, despite having been in existence for more than 2 decades, variability in defining abuse and neglect as it pertains to in utero substance exposure and inconsistencies in interpretation and implementation of legislation at the state level have made it difficult to assess the impact of Plans of Safe Care. When used as a tool for care coordination, health care providers, in collaboration with child protective services and community-based organizations, can use Plans of Safe Care to improve outcomes of infants and families affected by substance use disorder. This review summarizes the background and core components of Plans of Safe Care.