In 2017, the Governor and General Assembly directed the Secretary of Health and Human Resources to convene a workgroup to study barriers to the identification and treatment of substance-exposed infants (SEIs) in the Commonwealth of Virginia. In 2018, following the workgroup’s recommendations, the General Assembly enacted Chapter 695 of the 2018 Acts of Assembly [HB1157] which amended the Code of Virginia §32.1-73.12 to identify the Virginia Department of Health (VDH) as the lead agency to develop, coordinate, and implement a plan for services for substance-exposed infants. VDH is required to submit a report to the General Assembly regarding implementation of the plan by December 1 of each year.

The code also required VDH to work cooperatively with designated stakeholders to carry out its duties. VDH therefore convened a workgroup to develop and implement a plan for SEIs. The workgroup created a plan which they entitled the “Pathways to Coordinated Care (PCC) Strategic Plan" (PCC Strategic Plan). The PCC Strategic Plan is now the official plan for services for SEIs in the Commonwealth. The workgroup met from 2018 to 2021 and was on hiatus from 2022 to 2023 due to the COVID-19 pandemic and staff capacity. VDH has planned to reconvene the workgroup in late 2023 or early 2024. Summary points from this report are listed below.

2023 REPORT SUMMARY

1. Over the past year, VDH staff have reviewed the PCC Strategic Plan and identified areas for the workgroup to focus on once reconvened; planned for ways to reengage the workgroup; begun to increase staff capacity to support plan implementation; and continued to collaborate with stakeholders across the state on perinatal substance use and ongoing work to address this issue.

2. VDH has identified a need to reevaluate and update the PCC Strategic Plan to reflect the post-COVID-19 pandemic landscape. The workgroup initially developed the PCC Strategic Plan based on a pre-pandemic environmental scan. The scan likely needs to be carried out again to account for several factors, including the time that has passed since the workgroup conducted the scan and the impact of COVID-19 on both the healthcare workforce and resources involved in caring for individuals with substance use and mental health issues. Additionally, since the plan assigned specific stakeholders a variety of responsibilities, it is necessary to confirm whether previously assigned stakeholders still have the capacity to carry out those responsibilities or if they need to be reassigned.

3. VDH is currently working to increase its staff capacity to move the PCC Strategic Plan forward. Due to position vacancies, VDH has only recently had the staff to lead this work. VDH is currently in the interview process to hire a dedicated coordinator that will rebuild the workgroup.

4. The current PCC Strategic Plan is included in this report as Appendix D. It includes objectives that fall under four main areas: screening, coordination, education, and communication. Each objective includes the groups responsible for carrying out the work, a suggested time frame; identifies who will be served; and describes expected outcomes.