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 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 hired a coordinator, conducted informational interviews with people involved in the developing the initial plan, and reconvened partners across the Commonwealth in October 2024. Summary points from this report are listed below.

2024 REPORT SUMMARY

1. Over the past year, VDH expanded staff capacity to support the implementation of the PCC Strategic Plan by hiring a Substance-Exposed Infants (SEI) Plan Coordinator. This position will be responsible for coordinating activities related to the PCC Strategic Plan, including facilitating work group meetings, providing edits and updates as needed, planning regional listening sessions, and connecting with partners working on substance use in the perinatal population. The SEI Plan Coordinator has already been instrumental in working to re-connect those originally involved in the writing of the PCC Strategic Plan and developing a strategy for engaging stakeholders to move the plan forward.

2. VDH identified a need to reevaluate and update the PCC Strategic Plan in 2023 to reflect the post-COVID-19 pandemic landscape. In addition, 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. To update the PCC Strategic Plan, VDH intends to reengage stakeholders in the field and develop workgroups of stakeholders who will iterate on the plan. VDH began this work in October 2024 by holding a webinar for more than 160 partners on the PCC Strategic Plan and its implementation and issuing a survey to stakeholders. The survey offered the opportunity for stakeholders to provide feedback on the plan and to volunteer to be part of a work group that will update the plan.

3. VDH has maintained routine meetings with sister state agencies integral to this work, as well as connections with partners providing both clinical and non-clinical services to affected women and their families over the past year. In addition, state maternal and infant health data has been routinely reviewed with consideration for how Virginia can better assess substance use in the pregnant and postpartum period, as well as impacts on infants and developing children.

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.