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inconsistent practices around when toxicology screens are used

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Universal testing is expected (working on making this consistent), toxicology testing is based on criteria including physical evidence of substance use or altered mental status, no prenatal care, scant or late prenatal care, incarceration in pregnancy, history of removal of child from custody, history of verbal or positive test suggesting substance use within the year of the pregnancy, unexplained placental abruption, newborn with signs of withdrawal. We report when we have concerns regardless of toxicology test results, however we find the counties won’t often act unless the infant has biological evidence of the substance exposure. So, we report all positive cord samples EXCEPT if cord is positive for marijuana but mother reports cessation before birth and she herself tests negative at admission (new change at UCH given the senate bill change).

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"unofficial" lists shared among hospitals of folks w/ previous child welfare involvement due to substance use

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"unofficial" lists shared among hospitals of folks w/ previous child welfare involvement due to substance use

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screening often includes alcohol and cigarettes, but toxicology generally does not

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screening often includes alcohol and cigarettes, but toxicology generally does not

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Child welfare would like to hear about behavioral concerns more than testing results.

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screening practices aren't always done in a way that feels pt. centered, can be stigmatizing and discourage people from seeking treatment/disclosing use

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Enough capacity for treatment that referral would not involve waitlist

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Prenatal screening is inconsistent as is screening on admit to our hospital. Mother's who endorse substance use should have toxicology testing done, but this is also inconsistent. 

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Prenatal screening is inconsistent as is screening on admit to our hospital. Mother's who endorse substance use should have toxicology testing done, but this is also inconsistent. 

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universal screening, standardized testing where testing is concerned

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universal screening, standardized testing where testing is concerned

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Minority over representation who are tested

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bias and subjectivity play a role in testing and screening

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bias and subjectivity play a role in testing and screening

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At the state level, set expectation for universal screening and set standard criteria for testing of mothers and newborns so that bias can be reduced

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I'd like to see more communication with mothers and families around screening and testing.

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not clear messaging from what info needed from child welfare -- behavior vs testing

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Work group comes to consensus on standardized testing criteria, truly make a point to rely less on biological testing at county level when making a report

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Universal screening that takes place and/or is unpacked in a relational context

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Universal screening that takes place and/or is unpacked in a relational context

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various policies related to consent around toxicology testing

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"universal screening" will undoubtedbly bring bias results - as it already has done. If patients have to opt in to training we will see less of a bias. Also, providers get to decide what 'no prenatal care' means, and sometimes - we have seen that also include clients that get midwifery care be recorded as having no prenatal care - which contradicts that basis - either way, families should opt in for testing. 

# data[].attributes.subject
"universal screening" will undoubtedbly bring bias results - as it already has done. If patients have to opt in to training we will see less of a bias. Also, providers get to decide what 'no prenatal care' means, and sometimes - we have seen that also include clients that get midwifery care be recorded as having no prenatal care - which contradicts that basis - either way, families should opt in for testing. 