1. (a)

   1. (1) The Division of Children and Family Services believes in coordinating with other state agencies and community partners to help strengthen and support families in an effort to prevent child abuse and neglect.
   2. (2) The goal of prevention of child abuse and neglect extends to all families.
   3. (3) However, as guided by the Comprehensive Addiction and Recovery Act of 2016 (CARA), Pub. L. No. 114-198, along with the Child Abuse Prevention and Treatment Act of 1988 (CAPTA), Pub. L. No. 93-247, as amended, the division is specifically tasked with collaborating across systems to address the needs of substance-exposed infants to prevent future child maltreatment of this vulnerable population.

2. (b) The division, in coordination with other state agencies and community partners, strives to address the needs of substance-exposed infants primarily through two (2) approaches:

   1. (1)

      1. (A) Addressing the needs of substance-exposed infants who are defined as neglected pursuant to Arkansas Code § 12-18-103(14)(B)(i)(a)and (b) (i.e., Garrett’s Law referrals) and the needs of their families via an investigative response.
      2. (B) For more information regarding this approach, please see 9 CAR § 40-313, investigation of child maltreatment reports; and

   2. (2)

      1. (A) Implementing a referral process for healthcare providers involved in the delivery and care of infants to report, for the purpose of an assessment not related to a child maltreatment investigation, infants who have not been neglected as defined in Arkansas Code § 12-18-103(14)(B)(i), but who are born with and affected by:

3. (i) A fetal alcohol spectrum disorder (FASD);

   1. (ii) Maternal substance abuse resulting in prenatal drug exposure to an illegal or legal substance; or

      1. (iii) Withdrawal symptoms resulting from prenatal drug exposure to an illegal or a legal substance.

      2. (B) “Affected by” means:

         1. (i) An infant exhibits a condition or conditions associated with the mother’s use of alcohol during pregnancy or a healthcare provider has an articulated concern that the infant suffers from a fetal alcohol spectrum disorder;
         2. (ii) An adverse effect or effects in physical appearance or functioning that are:
4. (a) (a) Either diagnosed or otherwise observed; and

5. (b) (b) A result of the mother’s use of a legal or illegal substance during pregnancy; or

   1. (iii) An infant exhibits withdrawal symptoms in physical appearance or functioning as a result of the mother’s use of a legal or illegal substance during pregnancy.

      1. (C) “Infant” means any child thirty (30) days old or less.

         1. (c) The remainder of this policy and related procedures are specific to subdivision (b)(2) of this section, herein after referred to collectively as prenatal substance exposure referrals and assessments.
         2. (d)
   2. (1) Healthcare providers involved in delivery or care of infants are required to make prenatal substance exposure referrals to the Child Abuse Hotline.
   3. (2) The Child Abuse Hotline will accept prenatal substance exposure referrals.
   4. (3) Upon receipt of a prenatal substance exposure referral from a healthcare provider, the Child Abuse Hotline will assign the referral to the division for a referral and assessment (R and A).
   5. (4) The request for division assessment screen accommodates instances where an individual is not reporting maltreatment but is requesting an assessment and appropriate services for the family based on an assessment of the family’s strengths and needs.

6. (e)

   1. (1) Prenatal substance exposure referrals will be assigned to the appropriate county-level differential response (DR) staff (though prenatal substance exposure referrals are separate and apart from differential response allegations).
   2. (2) For a prenatal substance exposure referral to be considered initiated, DR staff must make face-to-face contact with the infant or at least one (1) parent of the infant within seventy-two (72) hours of receipt of the referral from the hotline.
   3. (3) If the infant and parent/caregiver are not seen together at the initiation, then DR staff must make face-to-face contact with the individual not seen at initiation within five (5) calendar days of receipt of the referral as well any other adult household members within the same five-calendar-day timeframe.
   4. (4) During each contact with the parent or parents/caregiver or caregivers, DR staff are responsible for engaging the family in an assessment of strengths and needs and developing a plan of safe care for the family.
   5. (5) The plan of safe care will be designed to ensure the safety and well-being of an infant following the release of the infant from the care of a healthcare provider and include content that addresses the health and substance use disorder treatment needs of the infant and affected family or caregiver.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: "01/2020"