The most frequent reason for considering DCS referral of a patient in the NICU is maternal substance abuse.  Each of these cases and families must be considered individually.  The nursery social worker will be instrumental in helping the team make hard decisions about referral.

Factors which the team should consider include the maternal history and social supports, the mother’s behavior toward her infant, and her willingness to cooperate with necessary treatment for herself and her child.  The infant’s degree of medical vulnerability is also a factor.

DCS referral is indicated if parental visits and calls are infrequent or inappropriate, if the mother has no stable home or support system for herself or her infant, if the mother continues to abuse drugs and/or is unwilling to participate in therapy, if the family already has an outstanding DCS case or if the mother has other children which have been removed from the home, or if the infant is medically-needy and concerns about mother’s ability to perform home care or comply with necessary medical follow-up is questioned.

DCS referral may be deferred if the parents visit frequently and behave appropriately, if the mother has a stable home and support system, and if she demonstrates willingness to be treated.

Discussed at Collaborative Pathways meeting 6/23/99.