The Comprehensive Addiction and Recovery Act (CARA), signed into law in 2016, was the first major federal legislation related to addiction in 40 years.
Legislative Background
- In 2003, the Child Abuse and Prevention Treatment Act (CAPTA) required Plans of Safe Care (POSC) for infants affected by illegal substance abuse.
- In 2010, an amendment added infants affected by fetal alcohol spectrum disorder (FASD).
- In 2016, the Comprehensive Addiction and Recovery Act (CARA) expanded the POSC requirement to include infants:
- exposed to any substance abuse during pregnancy
- with substance withdrawal symptoms after birth
- suspected of having FASD
What Needs To Happen In Vermont
- A POSC should be developed for all substance-exposed infants — before they are discharged from the hospital after birth.
- It should be created with the parents/caregivers (ideally started prenatally), saved in the infant’s medical record, and shared with the infant’s primary care provider to facilitate communication and ensure follow-up of any new referrals placed after birth.
- A de-identified CAPTA notification form should be completed for substance-exposed newborns and submitted to the Family Services Division for annual reporting to the Children’s Bureau.
Guidance Documents
- A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders
- DCF Memo to Hospitals
Frequently-Asked Questions
- FAQs: Vermont Newborn Plan of Safe Care
- FAQs: Vermont CAPTA Notifications
- FAQs: Marijuana Use During Pregnancy
Vermont Resources
Forms for hospitals:
- CAPTA Notification (form for hospitals, pdf)
- Newborn Plan of Safe Care (form for hospitals, fillable pdf)
Flowcharts:
- CAPTA Requirements Related to Newborns Exposed to Substances (flowchart pdf)
- CAPTA Requirements Related to Substance Use (flowchart pdf)
Flyer for families:
- Plan of Safe Care for Families (flyer for families, pdf)
Have Questions?
Send an email to AHS.DCFFSDCAPTA@vermont.gov.