The Comprehensive Addiction and Recovery Act of 2016 (P.L. 114-198) and the Child Abuse Prevention and Treatment Act, and Maryland law (Annotated Code of Maryland, Family Law Article § 5-704.2,) require that healthcare providers (HCPs) involved in the delivery or care of a newborn notify a Local Department of Social Services (LDSS) if a newborn is born substance-exposed.
Under Maryland law, a HCP must report a newborn under 30-days-old as a SEN if the newborn:
Displays a positive toxicology screen for a controlled substance as evidenced by any appropriate test after birth;
Displays the effects of controlled drug use or symptoms of withdrawal resulting from prenatal controlled drug exposure as determined by medical personnel; or
Displays the effects of FASD.
The Department developed a resource, Health Care Providers’ Substance Exposed Newborn Referral Guide, for HCP’s working with newborns and their caregivers. The guide provides a visual representation of the sequence of steps and decisions needed to determine whether a HCP should make a SEN notification to the LDSS. The guide includes the updates to the law made in 2018, altering the reporting requirements.
Substance Exposed Newborns are a population considered at great risk because a newborn who has been exposed prenatally to a controlled substance may have various medical conditions that require consistent care and may result in long-term adverse effects. A comprehensive assessment to determine a family’s strengths and needs and locate services for the newborn, parents, and family members results in a healthy approach that can ensure that children are safe, adequate needs are met, and families are together.
With this program, the Department aims to:
Decrease the number of SENs placed in foster care
Increase the number of families engaged in community resources after the birth of a SEN to reduce safety and risk factors to preserve families
Increase access to treatment resources and community resources across a broad continuum (SUD; mental/behavioral health; employment) promoting well-being for families engaged with child welfare
When notifying a LDSS of a SEN, the HCP must:
Make an oral report to the LDSS as soon as possible, and
Make a written report to the LDSS not later than 48 hours after the contact, examination, attention, treatment, or testing that prompted the report.
HCPs are encouraged to utilize the State of Maryland-Child Protective Services Report of Substance Exposed Newborn form (DHS/SSA2079) when making a written report to the LDSS.
Please download this fillable pdf form 3010 and complete the entire form (all applicable questions). Once completed, electronically sign the form and email, scan, fax or mail the form to the LDSS where the newborn is expected to reside with the parent or caregiver.
The LDSS will screen each SEN notification to determine whether the newborn meets the definition of a SEN. It is important that HCP’s or other mandated reporters provide as much information as possible, as requested on the Report of Substance Exposed Newborn form, to aid child welfare staff in determining the appropriate case assignment and completing a thorough assessment.
If the newborn does appear to meet the definition of a SEN, the LDSS will “screen in” the notification as a Risk of Harm-Substance Exposed Newborn. Notifications that are “screened out” as not meeting the SEN criteria may still be assigned for an Risk of Harm assessment depending on the family’s ability to care for the child or other issues that suggest that the family would benefit from an assessment of the risks and needs of the family to provide appropriate services if the notification is determined to benefit from engagement with the LDSS. If at any point, it appears that a child has been abused or neglected, the LDSS may investigate.
The LDSS will make contact and initiate the assessment of the newborn and mother within 48 hours. A child welfare professional will gather as much information about newborn, parents, caregivers, and family members to identify strengths, address any safety concerns, identify services to support the family, and develop a Plan of Safe Care.
The LDSS will aim to complete its assessment within 30 days or, if not possible, within 60 days to determine what, if any, continued services the newborn or family will need.
LDSS will continue to monitor safety and service needs of the newborn, family and caregivers, throughout the life of the case with the agency.