Santa Clara County, California
Perinatal Substance Abuse Protocol
Letter to Perinatal Health Care Provider
August 1, 1994
Change in protocol since signed August 1, 1994:
Please contact Raj Gill (408) 792-5158 or 792-5055
for further information or to arrange a meeting at your facility.
Dear Perinatal Health Care Provider:
The problem of perinatal substance abuse affects patients at all social and economic levels and has been well documented in the medical literature. According to the recent state-wide Perinatal Substance Exposure Study, on an average day in Santa Clara County eight babies are born with alcohol or other drugs in their systems. In addition, it is known that many more babies are exposed to alcohol and other drugs at some time during pregnancy.
The Santa Clara County Board of Supervisors has passed a protocol for dealing with substance exposed infants. This was required by Penal Code Section 11165.13 and Health and Safety Code Section 10901. The law requires participation between public and private health care providers, hospitals and county health and welfare departments. The law mandates the development of and dissemination to health care providers of a perinatal substance abuse protocol for use with all pregnant and post-partum women and requires that screenings and assessments be carried out by health practitioners or medical social workers. The law is intended to assure the provision of treatment, support and community services to help the mother, her child and family. It does not impose criminal sanctions for the actions of the mother.
For the effective implementation of the law, the Board of Supervisors included prenatal evaluation as well as in-hospital evaluation in the protocol. An appropriate screening questionnaire must be completed for each prenatal patient. Based on the results of this screening and clinical judgment, further assessment of the patient may be indicated. This assessment should be carried out by a health practitioner or medical social worker with special training.
In Santa Clara County the Alcohol and Drug Services Department has been charged by the Board of Supervisors with implementing the protocol and receiving the quarterly statistical reports. This protocol was developed by the Perinatal Alcohol and Drug Use Coalition, with consultation with many providers in both the private and public sectors. We have included copies of the protocol guidelines for both the screening and full assessment of prenatal patients, as well as a summary of the law. Screening protocols will also be put into effect in hospitals.
A multi-disciplinary protocol implementation team is offering on-site informational meetings about the protocol requirements to hospital personnel and medical staffs as well as other health organizations. Whether you are involved in perinatal care as an obstetrician, pediatrician or family practitioner, we hope that you will avail yourself of the opportunity to attend one of these meetings.
The use of the protocol’s screening and assessment tools during prenatal care may serve as an opportunity for intervention and preventive care. This could be not only of health benefit to a family unit, but also of significant economic benefit to society. For these reasons we have also enclosed a list of alcohol and drug treatment services for pregnant and post-partum women.
You may contact Sharlene Carlson at (408) 885-4076 for further information or to arrange for a meeting at your facility.
We thank you in advance for your cooperation and anticipated compliance with the protocol. Sincerely,
Robert Garner, Director Fred Schlichting, M.D., Medical Consultant
Alcohol and Drug Services Department Perinatal Alcohol and Drug Use Coalition
Duty to Assess Maternal Substance Abuse
Prenatal Screening and Assessment Flow Sheet and Screening Questionnaire
In-Hospital Screening and Assessment Flow Sheet and Screening Questionnaire
Substance Abuse Assessment and Guidelines
Santa Clara County Alcohol and Drug Treatment Resource List
Board of Supervisors: Michael M. Honda, Zoe Lofgren, Ron Gonzales, Rod Diridon, Dianne McKenna
County Executive: Sally R. Reed