Connecticut’s unique approach to complying with federally mandated reporting guidelines concerning infants with prenatal substance exposure (IPSE) has yielded positive results, according to a recent study by the University of Connecticut (UConn).
The study, first outlined by UConn Today, found that since 2019, the state’s hospital reporting infrastructure has worked to divert IPSE without safety concerns from Child Protective Services (CPS) using a deidentified notification system and a plan of safe care (POSC), according to the study. Connecticut is the first state to implement a separate, deidentified notification system.
The reporting system was developed in response to the federal Child Abuse Prevention and Treatment Act (CAPTA), which mandates that states notify CPS of occurrences of infants being exposed to drugs and alcohol. While the policy was created to protect children, it has led to the unintended consequences of fewer pregnant people using health care and treatment services and higher rates of neonatal opioid withdrawal syndrome, according to the study.
Connecticut still makes these federally mandated notifications, but it deidentifies the data and walks the person making the notification through a brief risk assessment to determine whether the case requires a separate maltreatment report, according to the report. In accordance with the federal legislation, Connecticut CAPTA also mandates that a plan of safe care be developed for all IPSE at or by the time of notification.
The study found that Connecticut’s system has diverted over half of the IPSE cases away from CPS and possibly the foster care system and instead directed them to community support systems and services.
However, while the reporting system has worked well in supporting the health and well-being of newborns and their caregivers, the study found racial disparities among infants that were reported.
While non-Hispanic White mothers were the most common group represented in the reporting data, accounting for 44 percent of notifications, Black mothers were disproportionately represented, accounting for 22 percent of the cases reported. The study concludes that the nonuniversal screening practices may be contributing to the racially disproportionate implementation.
Additionally, while the CAPTA system was intended to address opioid misuse, according to the study, its implementation has revealed a much greater use of marijuana in pregnant people than opioids. According to the study, the Connecticut CAPTA identified four marijuana exposures for every opioid exposure.
