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October 2008Vol. 9, No. 8Implementing CAPTA Requirements to Help Substance-Exposed Newborns

The impact of substance abuse on the well-being and safety of children is receiving increasing attention. Working to ensure the well-being and safety of children, professionals from child welfare, substance abuse, medicine, early intervention, and other disciplines are combining efforts and strengthening collaborations to meet the needs of families impacted by substance abuse. Nearly a decade ago, with the release of Blending Perspectives and Building Common Ground: A Report to Congress on Substance Abuse and Child Protection, the Federal Government discussed this issue and the importance of bringing systems together. This document noted the inherent complexity of substance abuse impact and stressed that no one discipline could address the issue alone.

The reauthorization of the Child Abuse Prevention and Treatment Act (CAPTA) in 2003 highlighted the impact on the youngest children touched by substance abuse—infants. This legislation specified that States must have:

  • Policies and procedures to address the needs of infants who are substance-exposed, including notifications of child protective services
  • A plan of safe care for infants
  • Procedures for immediate screening, risk, and safety assessment and prompt investigation of reports relating to substance-exposed newborns

In response to these requirements, the Children's Bureau released an announcement to support demonstration projects that would develop model policies and procedures to implement these provisions of CAPTA. In 2005, the Children's Bureau awarded four 5-year grants focused on systems change and multidisciplinary collaboration. Grantees spent the first year as a planning year. Years 2 and 3 focused on implementation and evaluation, while the final years require the projects to focus on dissemination. Funded projects are:

  • Denver Department of Human Services: Colorado Systems Integration Model for Infants (C-SIMI) Project
  • Massachusetts Department of Public Health: A Helping Hand: Mother to Mother
  • St. Vincent Mercy Medical Center: Healthy Connections Substance-Exposed Newborns Program
  • University of Oregon: Family Early Advocacy and Treatment

Although the four projects are located in different types of agencies and have developed unique approaches to comply with CAPTA requirements, they have arrived at some similar recommendations and lessons learned. Common essential components of these projects include:

  • Clarity and consistency in policies and procedures
  • Collaboration across disciplines (including health care, child welfare, substance abuse treatment, early intervention systems and others)
  • A champion within each system to lead the effort
  • Regular meetings among the stakeholders, development of common language, and buy-in at all levels
  • Review of legal issues, including consent procedures for sharing client information

The projects are now working on disseminating details of their experiences through workshops and publications. The knowledge gained from these projects has great potential for informing various disciplines working with newborns, children, and parents impacted by substance use. The lessons learned also are a potential resource for States that are still working on these provisions of CAPTA or seeking to improve their policies and procedures on this issue.

For additional information on this cluster of grants, please contact the Federal Project Officer, Catherine Luby, at

Contributed by Catherine Luby, the Children's Bureau, Office on Child Abuse and Neglect