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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. 

PFML
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.

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  • PFMLA
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  • pregnancy plan
  • Plan of Safe Care

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Comments (2)

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Alex Risley Schroeder posted:

Moms, and families, are in charge of the pregnancy plan, and the larger development of a team of support in this model. Have you experienced something like this? What worked? What could have been different? Was talk of ACES explicit, or implicit? 

Alex

Massachusetts Essentials for Childhood

Alex:

I think talk of ACEs can be explicit but works best when it comes from parent to parent. I'm not for screening of people & ACEs but think helping people understand generational impact of trauma can be done well by sharing info about ACEs and encouraging people to share info. with family and friends and partners. It's such strong context and, as important as showing how prevalent ACEs can be.

It's also validating for showing that some people have few, or none, and that can dispel some of the try harder/be better messages thrown on parents that often fail to acknowledge context. I like the expanded ACEs survey best because it includes homelessness, being in the foster care system, racism, community violence, and bullying. I don't think any list can be long enough to cover everyone and everything.

My experience sharing with parents is mostly online, in parent groups, in person, at writing groups, and in art shows that are interactive and not just for parents.

But I'm going to tag a few folks like @Laurie Udesky who has written stories, and @Karen Clemmer who has experience and knowledge about working with parents who are struggling with substance use/abuse/addiction and knows a lot of research. Also, @Louise Godbold who can share varied ways ACEs are shared with parents as part of her work.  

Cis

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