Improving Treatment for Drug-Exposed Infants
Treatment Improvement Protocol (TIP) Series 5

Training in Legal And Ethical Issues

Groups, agencies, and individuals caring for a drug-exposed infant must clearly understand and address all aspects of the complex legal and ethical issues involved, so as to achieve the best possible care and positive outcome for the infant.

In order to ensure a positive outcome, all staff involved with a drug-exposed infant should participate in comprehensive and continual training that covers every aspect of the recommendations presented in the preceding sections. This training should be developed at the Federal level in collaboration with the States, and should include specific examples illustrating how the recommendations can be applied in a variety of environments and circumstances.

1. The first level of training should be provided by the Federal Government to staff of State health and social services departments. Once trained, these staff will become better able to evaluate and recommend improvements to institutions and programs serving drug exposed infants.
2. The next level of training will be delivered by States to local municipalities, so as to inform local service providers of new or clarified guidelines concerning the care of substance abusing women and their infants. In addition to providers of health and social services, persons who interface with and are involved in the court process should receive training. Judges are a priority target group for training. Attorneys, probation officers, and other court personnel should be encouraged to participate in training. Training should be made available to any person involved in making decisions for drug-exposed infants and their families. Cross-training of groups encompassing health professionals, child welfare specialists, and judges and attorneys involved in family law is particularly encouraged.
3. The final level of training must occur at the local level and target specific agencies involved in the care of substance-abusing women and their drug-exposed infants. This training must also include the necessary tools for documenting overall compliance with the guidelines.
4. Training at all levels must be ongoing and updated at regular intervals to provide the most up-to-date information - including any changes that may occur in the law and these guidelines - to all groups, agencies, and individuals involved with care of substance-abusing women and their infants.
5. New training dollars should be made available at the Federal level to ensure compliance with these guidelines.