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A community-based approach to supporting substance exposed newborns and their families


Massachusetts Essentials for Childhood (MA EfC) is excited to present "The Elements of an Effective Plan of Safe Care." This information brief highlights a community-based approach to supporting families and newborns affected by substance use. MA EfC developed this brief to address the profound intersection between the Massachusetts opioid crisis, Federal mandates for the development of Plans of Safe Care for substance exposed newborns, and, the MA EfC focus on increasing social connectedness as a means to reduce child maltreatment.Plan of Safe Care

This brief identifies key elements of an effective community-based approach to caring for substance exposed newborns and their families. It builds from the work of the Franklin County (MA) Perinatal Support Coalition and their EMPOWER Program, including their Pregnancy Plan tool.

pregnancy plan

The brief includes video footage of conversations among Coalition members about the EMPOWER Program. Listening in on these video-taped conversations provides insights into how a community can create a community-wide strategy to support the well-being and safety of substance exposed newborns, and how partnerships between diverse providers, including treatment providers, state agencies and hospitals can build linkages that meet families where they are. The elements are:

  1. Access to a continuum of care
  2. Collaboration across providers within the community
  3. Peer coaching

  4. Holistic support, and
  5. A priority on family unity whenever possible.

While federal law does not require a Plan of Safe Care until the child is born, the Massachusetts Essentials for Childhood Initiative believes EMPOWER is particularly effective because it gets a plan in place before the child is born. The work of the EMPOWER program demonstrates a well-conceived, well-run, community-supported plan. EMPOWER engages with pregnant and parenting women to support families with newborns affected by substance use and to keep as many newborns safely at home with their families as possible. Research indicates that, when possible, keeping children at home supports vital bonding between mothers, newborns and family members and reduces child maltreatment. Further, separating infants from their birth parent contributes to poor outcomes for both the parent and infant including relapse for women; and poor attachment and failure to thrive for infants. The elements outlined build social connectedness, particularly of the mother, through building formal and informal networks and reducing social isolation.

The MA EfC Initiative is funded by a grant from the Center for Disease Control and Prevention (CDC). The reduction of child maltreatment through increasing economic supports and community social connectedness is at the center of the work of the Initiative. Other recent work includes an information brief on the benefits to children of Paid Family and Medical Leave (in MA), and, a video on the importance of social connectedness for families. 

Current work focuses on increasing access to earned income tax credits (EITC) through supporting VITA sites in health care settings, monitoring access to and uptake of Massachusetts’ new paid family and medical leave benefit, as well as the development of a Tool-Kit for Municipalities to build social connectedness.


Images (5)
  • PFML
  • PFML
  • pregnancy plan
  • Plan of Safe Care

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