What is the Plan of Safe Care (POSC)?
The Plan of Safe Care is a document created jointly by a pregnant or parenting woman, and her provider. This document helps women to think about what services or supports they might find useful, to record their preparations to parent and organize the care and services they are receiving.
A POSC can be any family service plan that covers both the parents’ behavioral health/recovery services (including addiction and mental health supports) and family or child-focused services (such as referral to Early Intervention and prenatal care appointments).
Who might coordinate a POSC?
A POSC coordinator is simply the person who works with the woman/parent/caregiver on creating and maintaining a plan, and identifying and accessing desired resources. Any provider working with perinatal clients (including recovery coaches, case managers, home visitors, doulas, Early Intervention staff, treatment providers, medical providers, etc.) can serve as a POSC coordinator, provided they have the availability to meet regularly for a period of time with the client/patient and are equipped to make warm referrals to needed services.
BSAS-licensed and/or contracted providers who have relationships with clients that last longer than 30 days are expected to make sure that all clients who are pregnant or parenting an infant have a POSC. Other perinatal service providers and healthcare providers are encouraged to screen pregnant and parenting women for substance use and offer either to coordinate a POSC for the client/patient or refer her to another provider who will coordinate the POSC.
What do providers need to know?
- If a POSC has already been created with one provider, there is no need to make a new one; the pregnant woman/parent/caregiver can choose who to work with, and can switch POSC coordinators at any time. Appropriate releases of information and personalized referrals should accompany any transition in POSC coordination.
- DCF screeners and response workers will now be asking everyone who files a 51-A report of a substance-affected birth or infant whether a POSC has been created. Clients/patients and providers should make sure to inform DCF at the time of filing that a POSC is in place and that referrals to appropriate services have been made.
- POSC coordinators should encourage clients/patients to sign releases of information so that their POSC can be shared with DCF and their other providers. This will help DCF make informed decisions, and will help all of the involved providers better coordinate care.
What does this mean for your work as a provider?
Providers may already be screening clients/patients and creating comprehensive service plans for those who have substance affected pregnancies or infants. In this case, the only new work will be reporting those plans as POSC to the birth hospital and/or DCF if and when a 51-A report is filed.
If providers are not currently screening or creating treatment/service plans with pregnant or parenting women, the Family Support Plan Template (PDF) | (DOC) can provide a useful tool to begin organizing this preparatory work. A POSC should be in place before hospital discharge following any substance affected birth.
Ideally, the POSC is a process that involves ongoing and coordinated work with a patient throughout the perinatal period, including connecting her to services and supporting her progress. The Plan of Safe Care Cover Page (PDF) | (DOCX) can be shared with the Birth Hospital or DCF as a record of that work. Alternately, if a woman presents for delivery and does not have a POSC, the patient can fill out the POSC Cover Page with the help of hospital staff.
There is no mandatory format or style for a POSC. If your organization already has a plan template that you use, you may continue to use that document as long as it addresses both the needs of both parent and child. A POSC must include contact information for the family, key providers, and documentation that referrals to needed services were offered or made for the pregnant woman/parent/caregiver.
Resources & Referrals
A personalized/“warm” referral is one that gives as much information as possible to the pregnant woman/parent/caregiver (detailed information about location of service, hours of operation, eligibility requirements, cost/insurance acceptance, services offered, etc.) Referrals should be made over the phone, if possible, where the pregnant woman/parent/caregiver and POSC coordinator together call the provider and an appointment is set up immediately.
A web-based resource repository with searchable, geographically-organized resources for pregnant and parenting women, and downloadable documents is available, to assist in the utilization of a POSC and the making of needed referrals.