Plans of Safe Care


Most new parents leave the hospital and enter the sometimes-scary world of being responsible for the safety and well-being of an infant. For a parent who struggles with substance use, addiction and its underlying stressors can make an already challenging time more difficult.

Children deserve to grow up with a family and research shows this is best for newborns and new parents. When safety concerns have been identified, caseworkers strive to help a parent address those concerns while keeping the family together. In 2019, in recognition of the unique opportunity to serve substance-exposed newborns and parents together and in response to changes in federal law, Colorado launched a Plans of Safe Care pilot to send parents and babies home from the hospital with a plan for safety. 

A Plan of Safe Care is meant to be a community safety net for families affected by substance use. Ideally, the plan is established during pregnancy, prior to child welfare involvement and the plan is developed by a multidisciplinary team. Plans of Safe Care include the following elements:

  • Physical health (postpartum care, support with breastfeeding, medication and pain management)
  • Behavioral health (engagement, treatment, recovery supports and retention; treatment for partner/other family members)
  • Infant health and development (high-risk follow-up care, with referral to specialty care; developmental screening and early intervention services; early care and education programs)
  • Parenting/family support (coordinated case management; home visiting/Head Start; Housing, employment support, child care and transportation)

Plans of Safe Care is a collaboration across many different agencies, committees and organizations, including the Substance Exposed Newborn Steering Committee, Plans of Safe Care Work Group, the CHoSEN Collaborative,  Illuminate Colorado and the Colorado Department of Human Services.

Plans of Safe Care FAQs

What is the Colorado Plans of Safe Care?

The Comprehensive Addiction and Recovery Act (CARA) of 2016 requires state child welfare systems develop a Plans of Safe Care to address the needs of infants who are identified as affected by substance abuse, experience withdrawal symptoms, or have fetal alcohol spectrum disorders (FASD).  It also stipulates the development of a services plan for the infant and their family/caregiver to ensure the safety and well-being of infants following the release from the health care provider.

What is included in the Colorado Plans of Safe Care?

  • Physiological Readiness of the Infant
    • The impact of substance exposure on the infant and identifies the need for special care, medical treatment or pharmacological care.
  •  Discharge Planning/Consultation
    • Nutritional and medical care needs and supplies, in-home caregivers, community resources, emergency care and transportation and assesses for safety of the home and financial resources.
  • Follow-up Care
    • Coordination and follow-up with PCP, pediatrician, treatment provider, counselor, home nursing care, housing, food and parenting resources.
  • Parent/Caregiver Education
    • Readiness of parent/caregiver to care for infant, education and skills needed to care for the infant and identifies support system.

Who is Involved in Developing the Colorado Plans of Safe Care (PoSC)?

The PoSC is developed with the input of a multidisciplinary-team before the mother’s discharge from the hospital. According to best practices, the PoSC should be started prenatally and serve as a living document throughout the pregnancy and after birth. If that is not possible, the PoSC must be developed after birth and completed before the mother’s discharge. This team may include:

  • Medical staff
  • Treatment providers
  • Mental health experts
  • Early childhood staff
  • Child welfare
Contact information

Shannon Bryan
Substance Use Disorder and Substance Exposed Newborn Specialist  
Division of Child Welfare

Pilot program in Larimer County


Impact on child welfare practice


Training and resources for professionals who work with kids and families

CHoSEN Collaborative

The CHoSEN Collaborative is an effort to increase consistency in the implementation of best practice in the identification of and response to newborns prenatally exposed to substances throughout the Rocky Mountain region. The cornerstone initiative of the CHoSEN Collaborative is focused on quality improvement. Known as “CHoSEN QIC”, this work is built around multidisciplinary hospital-based improvement teams working collaboratively to achieve measurable improvements.