What if we could prevent and reduce the instance incidence of substance-exposed newborns, reduce foster care costs and rates, and reduce NICU expenses, and long-term medical and special educational costs?  We can. The SHIFT (Safe, Healthy Infants, Families Thrive) Taskforce, built through the National Quality Improvement Center for Collaborative Community Court Teams, aims to provide comprehensive support to pregnant families identified as at risk of substance use disorder. SHIFT uses community collaboration to build systems of care that:

  • Ensure early identification of infants with prenatal substance exposure
  • Reduce time to service engagement for parents and infants
  • Increase cross-systems coordination and collaboration
  • Decrease the overall trauma exposure for the impacted family

First piloted in Maricopa County, the second pilot in Yavapai County is gaining momentum as community providers and the Department of Child Safety form a prenatal care network. In Yavapai County’s rural community, most providers know one another, but may not know where they fit in the spectrum of care or how they may collaborate. Now, all providers who work with women during the perinatal stage will engage in SHIFT to identify and intervene in families at risk for removal of their newborn due to substance use disorder.

The intervention point begins with the obstetrician, as women are most interested in change during pregnancy. While obstetricians are mandatory reporters, SHIFT optimizes their role as a mandatory supporter, too. By incorporating resource provider and obstetrician collaboration before and after birth, families can utilize recovery time, prenatal care, resources, and support to strengthen their case during a DCS investigation. This team preparation restores families’ dignity in caring for their new infant and helps to provide the best treatment for infants prenatally exposed to substances: a nurturing relationship with their parents.

The SHIFT Taskforce is a consolidated effort toward systems change. Meghan Hays Davis, Program and Training Director of Prevent Child Abuse Arizona and lead collaborator in bringing the SHIFT Taskforce to Yavapai County, shares, “We all know the importance of support for families when babies are born. When a baby is born with prenatal substance exposure, support is even more crucial. Not only that, if support starts at birth, we have missed a serious opportunity in prevention. If we want to see a reduction in harm, generational foster care, and poor health outcomes related to adverse childhood experiences, then we as a society have to take the best care possible of our youngest members- starting before they are born. And we can’t do that without also supporting families.”

In January, Prevent Child Abuse Arizona and Healthy Families Arizona hosted a system walk-through to prepare local obstetricians, substance use treatment specialists, home visitors, DCS, behavioral health, and family-serving professionals for their roles in providing coordinated care to these families. One attendee commented, “It’s great that we are getting connected to understand each role and working as a team to serve these families.”

Prevent Child Abuse Arizona thanks Blue Cross Blue Shield of Arizona for their support of this program.