Plans of Safe Care research and action

Substance use during pregnancy is a growing issue that demands data-informed, family-centered solutions. The Division of Child Welfare — which resides within the Office of Children, Youth and Families at the Colorado Department of Human Services — seeks to ensure that Plans of Safe Care can be developed at multiple entry points, incentivize cross-system collaboration, and develop a comprehensive data collection system to address the health, safety and well-being of any infants and families impacted by perinatal substance use and substance use disorders.

This page contains information about research and action on Plans of Safe Care in Colorado.

Implementation timeline

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Partner agencies and groups

• Illuminate Colorado
• SuPPoRT Colorado 
• Colorado Evaluation Action Lab
• The Kempe Center
• Behavioral Health Administration 
• CHoSEN
• HardBeauty

Perinatal linkage project

Colorado struggles to know what works to prevent prenatal substance use because the information exists in different systems. In 2019, Senate Bill 228 and subsequent legislation responded to this challenge by authorizing an innovative project to link data across systems. The Colorado Lab provides leadership for this statewide linkage project and companion studies. Findings inform what prevention measures improve outcomes for parents and their newborns.

Plan of Safe Care Pilot program

The Division of Child Welfare is resourcing a pilot in the San Luis Valley to develop a data-informed strategic framework for coordinated development and use of POSC. The goal of this pilot is to create a framework for coordinated POSC service delivery and tracking that can be scaled and sustained across Colorado. The focus is on defining processes for voluntary initiation and implementation of POSC in community-based spaces and with health and human service providers. Guiding features of the pilot include:

• Promoting voluntary family engagement in POSC
• Identifying multiple entry points for POSC initiation, outside of the birthing hospital
• Supporting providers for whom POSC is outside of standard practice
• Developing distinct pathways for notification and reporting to child welfare
• Exploring the role of Social Health Information Exchanges in maternal health innovation

IEPS Notification form rollout

While notification of all infants exposed prenatally to substances is necessary under the federal Child Abuse Prevention Treatment Act (CAPTA 106(b)(2)(B)(ii)), not all of these families require referral to child welfare for concerns of abuse or neglect (CRS 19-1-103(1)(a)(IV)). State and National research has shown that developing a distinct notification process can help alleviate provider concerns about reporting infants and their families to child welfare when they have not identified child maltreatment concerns. A distinct process can also help reduce stigma by clarifying that not all prenatal substance exposure is a concern for child maltreatment. Lastly, developing a notification pathway may help reduce fear and promote access to healthcare and substance use treatment for birth parents.

The Colorado Department of Human Services is launching a new process for the notification of infants exposed prenatally to substances known as the Infants Exposed Prenatally to Substance (IEPS) Notification form. An IEPS Notification is made for all instances of infants exposed prenatally to substances. It is not a report to child welfare and is not an indicator of child abuse or neglect. Notification is made even if a report to child welfare for concerns of abuse or neglect is not indicated. IEPS notification does not contain any personally identifying information about the family or infant.

CDHS is collaborating with Colorado Hospital Substance Exposed Newborns Collaborative (CHoSEN), The Kempe Center, Colorado Evaluation and Action Lab, Illuminate Colorado and others to support a phased implementation of the IEPS Notification Form among Colorado hospitals. More information on IEPS notification is available on the Plans of Safe Care FAQ page.  If you or your organization are interested in participating in an early phase of the implementation please email cdhs_IEPS@state.co.us.