New Mexico Register / Volume XXXVII,
Issue 12 / June 23, 2026
TITLE 8 SOCIAL
SERVICES
CHAPTER 3 FAMILY
HEALTH AND WELL-BEING
PART 2 PLAN
OF SAFE CARE FOR SUBSTANCE-EXPOSED INFANTS
8.3.2.1 ISSUING
AGENCY: New Mexico health care authority (HCA).
[8.3.2.1 NMAC - N, 7/1/2026]
8.3.2.2 SCOPE:
New Mexico health care authority, New Mexico
managed care organizations (MCOs), private insurance, children, youth and
families department (CYFD), department of health (DOH), early childhood
education and care department (ECECD), primary care providers, hospitals, birth
centers, supportive services providers, perinatal providers, substance-exposed
infants, birthing parents and their families, and caregivers.
[8.3.2.2 NMAC - N, 7/1/2026]
8.3.2.3 STATUTORY
AUTHORITY: Sections 9-8-6 NMSA 1978; 27-2-12 NMSA 1978;
and 32A-3A-13 NMSA 1978.
[8.3.2.3 NMAC - N, 7/1/2026]
8.3.2.4 DURATION:
Permanent.
[8.3.2.4 NMAC - N, 7/1/2026]
8.3.2.5 EFFECTIVE
DATE: July 1, 2026, unless a later date is cited at
the end of a section.
[8.3.2.5 NMAC - N, 7/1/2026]
8.3.2.6 OBJECTIVE: The
objective of this part is to establish standards and procedures for
identification of substance-exposed infants; development, implementation, and
monitoring of plans of safe care; coordination among state agencies, licensed
facilities, and medicaid contractors; data reporting;
and training, in accordance with the New Mexico Comprehensive Addiction and
Recovery Program (Chapter 156-Apr10).
[8.3.2.6 NMAC - N, 7/1/2026]
8.3.2.7 DEFINITIONS:
A. Definitions beginning with “A”:
(1) “Abused child” means a minor
under 18 who has suffered, or is at risk of, serious harm due to a parent,
guardian, or custodian’s actions or inaction. It includes physical, emotional,
or psychological abuse, sexual abuse/exploitation, abandonment, or negligent
treatment that endangers the child’s health or welfare (New Mexico Children’s
Code 32A-4-2 NMSA 1978).
(2) “Active efforts” mean a series of
affirmative, active, thorough, complete, and timely actions aimed at
maintaining or reuniting children with their families. This standard is higher than “reasonable
efforts”, which mainly involve service referrals. Active efforts require agencies to actively
engage and assist families in overcoming barriers to services. Key aspects of active efforts include
actively helping parents obtain services rather than just providing referrals,
ensuring efforts are culturally appropriate and involve collaboration with the
child’s tribe, working in partnership with the family and tribe, tailoring
efforts to each family’s specific needs, meticulously documenting all efforts,
including tribal cultures and traditions, and initiating these efforts promptly
and continuing them throughout the case.
B. Definitions beginning with “B”: “Birthing facility” means a licensed
hospital that provides labor and delivery services or a licensed birth center.
C. Definitions beginning with “C”:
(1) “CARA navigation program” means a
program overseen directly by the New Mexico health care authority or its
contractor that provides navigation services to CARA infants and families,
including support for facility CARA navigators in birthing hospitals and other
participating facilities.
(2) “CARA navigator” means an
individual designated by the New Mexico HCA or its designee or contractor. A
CARA navigator receives plans of safe care and notifications of
substance-exposed infants and provides care coordination services for infants,
parents, and families impacted by substance exposure. For purposes of Subsection
C of Section 32A-3A-2 NMSA 1978, a CARA navigator
serves as the care coordinator for substance-exposed newborns under this part
and is distinct from care coordinators employed by medicaid managed care organizations
who perform the care-coordination functions required under 8.308.10 NMAC.
(3) “CARA supports system portal”
means the electronic record of care owned and managed by HCA to provide
statewide access to plans of safe care and related documentation supporting
care coordination efforts for CARA families within the CARA navigation program.
(4) “Care coordinator” means, within
the context of the CARA program, a CARA navigator.
(5) “Caregiver” means child’s parents,
relatives, guardians, custodians or caregivers in the household who provides
care and supervision for the child.
(6) “Clinician” means a physician,
certified nurse-midwife, physician assistant, nurse practitioner, or other
prescribing provider licensed to interpret lab results and prescribe
medication.
(7) “Comprehensive Addiction and Recovery
Act (CARA)” means federal legislation signed into law in 2016 (Pub. L.
114-198, 130 Stat. 695).
D. Definitions beginning with “D”: [RESERVED]
E. Definitions beginning with “E”: [RESERVED]
F. Definitions beginning with “F”:
(1) “Facility CARA navigator” means an
employee or contracted representative who has on-site presence at birthing
facilities.
(2) “Family assessment” means a
comprehensive assessment prepared by CYFD at the time CYFD receives
notification of failure to comply with the plan of safe care to determine the
needs of a child and the child's parents, relatives, guardians, custodians or
caretakers, including an assessment of the likelihood of:
(a) impending danger to a child's
well-being;
(b) the child becoming an abused child or
neglected child; and
(c) the strengths and needs of the child's
family members, including parents, relatives, guardians, custodians or
caretakers, with respect to providing for the health and safety of the child.
G. Definitions beginning with “G”: “Guardian” means a person appointed as a
guardian by a court or by a Native American nation or tribal authority.
H. Definitions beginning with “H”:
(1) “Health care professional” means a
physician, physician assistant, nurse practitioner, nurse, licensed social
worker, midwife or other relevant professionals who provide health care
treatment to expectant or new parents or infants.
(2) “Home visiting” means a program
that delivers a variety of information, educational, developmental, referral
and other support services for eligible families who are expecting or who have
young children under the age of five. Home
visiting programs provider services that promote parental competence and early
childhood development by optimizing the relationships between parents and
children in their home environment.
I. Definitions beginning with “I”:
(1) “Impending danger” means when a
child is living in a state of danger or position of continual danger due to a
family circumstance or behavior. The
threat caused by the circumstance or behavior is not presently occurring but
can be anticipated to have severe effects on a child at any time (8.10.6.7
NMAC).
(2) “Indian child” means an Indian
person, or a person whom there is reason to know is an Indian person, under
eighteen years of age, who is not married or emancipated.
(a) A member of a federally recognized
Indian tribe; or
(b) The biological child of a member of a
federally recognized Indian tribe and is eligible for membership or citizenship
in a federally recognized Indian tribe. 25 C.F.R. 23.2, 23.
(3) “Indian Child Welfare Act (ICWA) of
1978 25 U.S.C. section 1901-1963” is a 1978 U.S. Federal Law designed to
protect the best interest of Indian tribes and families by the establishment of
minimum Federal standards for the removal of Indian children from their
families and the placement of such children in foster or adoptive homes which
will reflect the unique values of Indian culture.
(4) “Indian child’s tribe” means:
(a) The Indian tribe in which an Indian
child is a member or eligible for membership from a federally recognized tribe,
nation, pueblo; or
(b) In case of an Indian child who is a
member of or eligible for membership in more than one tribe, the Indian tribe
describe in section 23.109.
(5) “Indian Family Protection Act (IFPA)
of New Mexico, Section 32A-28-A NMSA 1978, et seq.” IFPA codifies into
state law the federal protections for tribes and their children and families
and strengthens and surpasses the requirements of previously existing laws. The passage is tribally led and reflects on
lived experience of tribal workers, tribal leadership, and impacted families to
ensure ICWA is protected.
(6) “Indian tribe” means any Indian
tribe, band, nation, or other organized group or community of Indian federally
recognized as eligible for the services provided to Indians by the secretary of
interior because of their status as Indian, including any Alaska Native village
as defined in section 2(c) of the Alaska Native Claims Settlement Act, 43
U.S.C. 1602 (c).
J. Definitions beginning with “J”: [RESERVED]
K. Definitions beginning with “K”: “Key household member” means any
individual who lives at the infant’s discharge address who is 18 years or older
and provides care for the infant listed on the plan of safe care.
L. Definitions beginning with “L”: [RESERVED]
M. Definitions beginning with “M”:
(1) “Managed care organization (MCO)”
means an entity that contracts with the HCA to deliver covered medicaid services to enrolled members, including to assist
the state in meeting the requirements established under Section 27-2-12 NMSA
1978.
(2) “Member” means a person enrolled
in medicaid or a medicaid
managed care organization.
N. Definitions beginning with “N”:
(1) “Navigation services” means
activities performed by a CARA navigator to receive and review POSCs and
notifications, coordinate referrals, document actions, and follow up with
families and providers.
(2) “Neglected Child” means a minor
under 18 who has been abandoned; lacks proper parental care and control or
subsistence, medical, or other care or control necessary for their well-being
because of the faults or habits of the child’s parent, guardian or custodian or
that person’s failure or refusal, when able to do so, to provide for them; or
whose parent is unable to care for them due to incarceration or incapacity (New
Mexico Children’s Code 32A-4-2 NMSA 1978).
O. Definitions beginning with “O”: [RESERVED]
P. Definitions beginning with “P”:
(1) “Parent” means a biological or
adoptive parent with a constitutionally protected liberty interest in the care
and custody of the child, or a person who has lawfully adopted a Native
American child pursuant to state law or tribal law or tribal custom.
(2) “Plan of safe care (POSC)” means a
written plan created with the birthing parent and family by a health care
professional or care coordinator intended to ensure the immediate and ongoing
safety and well-being of a substance-exposed infant experiencing sign or
symptoms of withdrawal or to provide perinatal support to a pregnant person
with substance use disorder by addressing the treatment needs of the child and
any of the child’s parents, relatives, guardians, custodians or caregivers to
the extent those treatment needs are relevant to the safety of the child.
(3) “POSC non-compliance” means a
failure by the infant’s family or caregivers to interact with the CARA
navigator or a failure to comply with statutorily required elements within the
POSC service or treatment plan.
(4) “Primary care provider (PCP)”
means a physician, nurse practitioner, physician assistant, or certified
nurse-midwife who provides, supervises, and coordinates primary health care for
the member, initiates referrals as needed, and maintains continuity of care.
(5) “Private insurer” means a private
insurance company from which an employer or an individual purchases a health
insurance policy.
Q. Definitions beginning with “Q”: [RESERVED]
R. Definitions beginning with “R”: [RESERVED]
S. Definitions beginning with “S”:
(1) “Safe” as used in this rule means
that there are no safety threats placing the child in present or impending
danger of serious harm.
(2) “Screening brief intervention referral
to treatment (SBIRT)” means an evidence-based model designed to identify,
reduce and prevent problematic substance use or misuse and co-occurring mental
health disorders as an early intervention approach. SBIRT includes a universal
verbal screening specific to age, a face-to-face brief intervention for
positive screening results, and a referral to behavioral health treatment and
services if indicated.
(3) “Service provider” means any state
or community agency working with CARA families as identified in the plan of
safe care (POSC).
(4) “Statewide central intake (SCI)”
means the unit within the children, youth and families department protective
services division (CYFD PSD) whose responsibilities may include but are not
limited to receiving and screening reports of alleged child abuse or neglect
and prioritizing and assigning accepted reports to the appropriate county
office for investigation.
(5) “Substance-exposed infant” means a
newborn who exhibits physical, neurological or behavioral symptoms consistent
with prenatal drug exposure, withdrawal symptoms from prenatal drug exposure,
or fetal alcohol spectrum disorder.
T. Definitions beginning with “T”: [RESERVED]
U. Definitions beginning with “U”: [RESERVED]
V. Definitions beginning with “V”: [RESERVED]
W. Definitions beginning with “W”: [RESERVED]
X. Definitions beginning with “X”: [RESERVED]
Y. Definitions beginning with “Y”: [RESERVED]
Z. Definitions beginning with “Z”: [RESERVED]
[8.3.2.7 NMAC - N, 7/1/2026]
8.3.2.8 CARA
PROGRAM: The overall objective of New Mexico’s
Comprehensive Addiction and Recovery Act (CARA) program is to support families
through trauma-informed and culturally responsive services that promote the
safety, health, and well-being of infants and their caregivers. The need for a CARA plan of safe care (POSC)
may be identified during prenatal care, during the delivery episode, or after a
child is born.
[8.3.2.8 NMAC - N, 7/1/2026]
8.3.2.9 IDENTIFICATION
OF SUBSTANCE EXPOSURE:
A. Providers must use an evidence-based
verbal screening brief intervention with referral to treatment (SBIRT) model at
prenatal medical visits and during delivery hospitalization to identify
substance use in pregnancy and to identify the appropriate level of treatment.
B. Infants are identified as substance
exposed when they are a newborn who has exhibited physical, neurological or
behavioral symptoms consistent with prenatal drug exposure, withdrawal symptoms
from prenatal drug exposure, or fetal alcohol spectrum disorder. Disclosure of substance use by a pregnant
person shall not trigger mandatory abuse and neglect reporting or testing
without clinical indication.
C. Birthing facility staff and
clinicians shall use an evidence-based tool to evaluate infants born affected
by substance use for withdrawal symptoms resulting from prenatal drug exposure
or fetal alcohol spectrum disorder.
D. Substance exposure includes babies
whose birthing parent was diagnosed with substance use disorder (SUD), alcohol
use disorder (AUD), or opioid use disorder (OUD). An infant born to a pregnant/birthing person
who is stable on medication for opioid use disorder (MOUD)/medication assisted
treatment (MAT) shall also require a POSC. Prescribed narcotic use during labor does not
equate to a substance use disorder and should not lead to a POSC creation.
[8.3.2.9 NMAC - N, 7/1/2026]
8.3.2.10 RESPONSIBILITIES
REGARDING PLAN OF SAFE CARE CREATION:
A. When an infant in New Mexico has been
identified as substance exposed, a POSC must be created by the birthing
facility staff or clinician who receives this information. All providers at birthing facilities, or
providers who perform prenatal medical visits, shall verbally screen for
substance use disorder in pregnant, birthing, and postpartum people and develop
a POSC when identifying substance use disorder in pregnancy. If the POSC has not been developed in the
prenatal period, it must be created prior to discharge from the hospital. Hospital providers should access the CARA
supports system portal to identify if a POSC has already been created. If not, these providers are required to create
the POSC upon identification of a substance exposed infant as defined in
Subsection B of 8.3.2.9 NMAC. To the
extent permitted by applicable federal and state privacy and confidentiality
laws, including HIPAA and 42 C.F.R. Part
2, notification of the active POSC shall be shared with the following parties
either in a physical copy, telecommunication or an electronic version.
(1) The child’s primary care provider.
(2) The child’s parent, relative, guardian
or caregiver.
(3) The CARA navigator/care coordinator.
(4) If the child’s parent, relative,
guardian, custodian, or caregiver is a tribal member or resides on tribal land,
the respective nation, pueblo, or tribe’s responsible entity as identified by
tribal leadership.
(5) If there is CYFD involvement due to
submission of a statewide central intake (SCI) or a family assessment, the
respective staff from CYFD will receive a copy from the CARA navigator if they
are not able to access the POSC via the CSSP.
(6) On request from the birth parent,
contact information and protected health information shall be redacted on the
copy of the POSC that is sent to other parents, caregivers, or guardians.
B. Protected health information
collected through CARA and POSC processes shall remain confidential within the
healthcare system.
C. Plans of safe care must be reviewed
with the birthing parent in the appropriate language for understanding.
D. A CARA POSC seeks to engage the
family in support and treatment services and is not on its own a referral to
CYFD. The CARA POSC does not replace a
report to the SCI system of CYFD.
E. In all instances when the hospital or
birthing facility suspects that a newborn is an abused or neglected child, or
that there is a risk of impending danger to the infant, the hospital or
birthing facility is required to report suspected abuse, neglect or impending
danger to CYFD SCI prior to the infant’s discharge. A newborn who is suspected to be an abused or
neglected child, or who may be in impending danger, may not be discharged until
CYFD has confirmed the safety of the infant’s placement with a parent or other
legally authorized caregiver in compliance with safe discharge rules at
8.370.12 NMAC.
F. Emergency department or urgent care
deliveries: In situations where a
delivery occurs before transfer can occur to a birthing facility, the staff in
the emergency or urgent care department shall initiate a POSC if the family
qualifies for one based on verbal screening or newborn evaluation.
G. Birthing facilities shall follow
existing laws regarding safe discharge for patients.
[8.3.2.10 NMAC - N, 7/1/2026]
8.3.2.11 REQUIREMENTS
OF THE PLAN OF SAFE CARE:
A. The POSC shall include the following
components:
(1) Referral to substance use prevention
and treatment programs for the pregnant or birthing parent or guardian unless
already engaged in treatment. In
situations where an individual is already engaged in treatment or recovery, the
details will be documented by the CARA navigator in the ongoing case management
documentation of the plan of safe care.
(2) Referral for a home visiting program
or an early intervention family infant toddler program.
(3) Indication that the CARA navigator is
engaging in communication, collaboration, and consultation with a child’s
nation, pueblo, or tribal social services/Indian Child Welfare Act (ICWA)
coordinator or specialist to ensure the POSC is developed in a culturally
responsive manner for each Native American and complies with ICWA and IFPA
requirements.
(4) Information about the child and the
child’s family, including:
(a) the child’s name, if available at
discharge;
(b) emergency contact name and phone
number of at least one of the child’s parents, relatives, guardians,
custodians, or caregivers. If the parent or caregiver state they do not have a
phone, they are required to provide contact information for someone they keep
in regular contact with who would serve as a contact for the CARA Navigator;
(c) the address of the child’s parent(s),
relatives, guardian, custodian or caregiver who will be taking the child home
from the hospital or birthing facility; and
(d) the names of the parents, relatives,
guardians, custodians, or caregivers who will be living with the child.
B. In all situations where a SCI report
or a CYFD family assessment referral is placed, the CARA navigator submitting
the SCI report or a CYFD family assessment will access the POSC for the child
in the CSSP and update the POSC to show that a SCI report or a CYFD family
assessment has been placed.
C. If an infant enters CYFD custody
after a POSC has been created, the POSC shall be modified by the CARA navigator
to address the needs of the infant in the new setting. The updated POSC shall contain the resource
family’s information and shall be re-sent to all entities required to receive
copies of the POSC.
D. The POSC may include the following
referrals:
(1) Public health agencies;
(2) Maternal and child health services;
(3) Infant mental health providers;
(4) Public and private children and youth
agencies;
(5) Courts;
(6) Local education agencies;
(7) Managed care organizations; and
(8) Hospitals and medical providers.
E. Non-participation in POSC required
services will require a referral to CYFD family services for a family
assessment as outlined in 8.3.2.13 NMAC.
[8.3.2.11 NMAC - N, 7/1/2026]
8.3.2.12 IMPLEMENTATION
OF THE CARA NAVIGATION PROGRAM:
A. All infants with a POSC shall receive
care coordination services through a CARA navigator. HCA shall oversee and monitor implementation
of 8.3.2 NMAC and shall assure compliance with applicable federal and state law,
including CARA and Section 32A-3A-13 NMSA 1978, by designating CARA navigators,
maintaining procedures for receipt and review of plans of safe care and
notifications, and initiating corrective action when required.
B. CARA navigators and CARA navigation
programs shall use an evidence-based intensive care coordination model that is
listed in the federal Title IV-E prevention services clearinghouse or another
nationally recognized EB clearinghouse for child welfare.
C. CARA navigators are direct agents of
HCA or its subcontractors who are designated to manage the CARA program and the
associated care coordination activities to:
(1) ensure the plans of safe care are
implemented and CARA families are supported;
(2) assure compliance with the
Comprehensive Addiction and Recovery Act and 8.3.2 NMAC; and
(3) collaborate with state agencies and
service providers to ensure continuity of care and implementation of the CARA
program.
D. CARA navigators shall:
(1) Complete a POSC if it was not
completed by the infant’s birthing facility discharge staff upon their initial
contact.
(2) Ensure that, if CYFD is involved, the
POSC is provided to the assigned investigator or other CYFD service provider
working with the family in the case of a family assessment.
(3) Send a copy of the POSC to the
infant’s PCP within seven business days of receiving notification for a new
POSC.
(4) Keep the parent or caregiver updated
and informed when changes are made to the POSC.
(5) Upon receiving a copy of or the
notification of new POSCs for each infant with substance exposure review plans
of care for completeness, ensure that a PCP is identified, assure that correct
insurance information is on the plan, and verify that all service referrals are
complete or in process and moving towards completion.
(6) Work directly with the infant and
family to ensure that necessary referrals are in place and, appointments are
scheduled and attended, and work with family on progression where progression
has stalled to support the family in sustaining engagement with services that
promote infant safety and well-being.
(7) Act as a liaison to MCOs or private
insurances if there is any issue in accessing necessary resources available
within their health plan such as substance use disorder treatment or home
visiting services.
(8) Act as the primary point of contact to
support coordination of the infant’s POSC related services while the family is
engaged in the CARA navigation program.
(9) If the CARA navigator is unable to
establish contact with the family after documented outreach that includes mail,
phone call, text and in-person efforts or identifies that the family has not
engaged in statutorily required services such as home visiting or substance use
disorder (SUD) treatment, the CARA navigator may continue good-faith engagement
efforts using supportive, non-punitive approaches unless criteria for case
closure is met. At this point non-compliance shall be determined and escalated
to CYFD as a referral for family assessment.
(10) The CARA navigator shall make a report
to CYFD SCI if the CARA navigator has immediate concerns for abuse or neglect.
(11) During any CYFD screening or
investigation, continue plan of safe care coordination and outreach and
document all contacts, services, and outcomes.
(12) If CYFD declines to open a case or
closes a case without custody, the navigator shall, within five business days:
(a) attempt contact with the family at
least three times using at least two modalities;
(b) schedule follow-up in the home to
establish the necessary intensity of engagement given CYFD decision in not
pursuing a custody situation within 14 days; and
(c) if safety concerns persist or new
information arises, make a new referral to CYFD SCI.
(13) A navigation case may be closed only
when navigation closure criteria in Subsection F of 8.3.2.12 NMAC are met.
(14) The CARA navigator shall collaborate
with the tribe, pueblo or nation in accordance with the tribe, pueblo or
nation’s expectations regarding interaction with tribal members.
E. Facility CARA navigator/care
coordinator: Are direct agents of the HCA or its subcontractor, who add
on-site presence of the CARA navigation program to birthing facilities. There shall be facility CARA navigator
coverage at every birthing facility in the state. Facility CARA navigators shall:
(1) Ensure that all CARA infants who have
a plan of safe care receive care coordination to implement the plan of safe
care.
(2) Communicate, collaborate and consult
with a child’s nation, pueblo, or tribe to ensure that plans of safe care are
developed in a culturally responsive manner for each child.
(3) Identify appropriate agencies to be
included in POSC based on an assessment of the needs of the child.
(4) Birthing facilities are required to
ensure CARA navigators have the necessary information about CARA infants. In addition, birthing facilities are required
to support CARA navigators with unit access, computer access as needed, and
hospital required training.
(5) The division of health improvement
(DHI) has the authority to monitor and enforce facility compliance including
the presence of CARA Navigators.
F. Navigation closure criteria:
A navigator may close a case when one of the following occurs:
(1) The family graduates from the CARA
program when the infant is 12 months old and the family and the CARA navigator
mutually agree that navigator services are no longer needed;
(2) The infant relocates out of state, or
other circumstances documented by the navigator make continued navigation
impracticable. The CARA navigator shall
attempt to connect the infant and family to medicaid
or care coordination in their new location; or
(3) For non-responsive, difficult to
engage families the CARA navigator shall refer to family services at CYFD for a
family assessment. If family services is engaged with the family and provides
services, navigator shall interact with family services to provide updated
documentation in CARA system of family services involvement.
(4) The infant’s nation, pueblo, or tribe is exercising inherent sovereign authority over
navigation case and has not requested state agency support. The CARA navigator shall document the name of
the contact person at the nation, pueblo, or tribe that is exercising authority
and shall close the CARA navigation case and cooperate in the transfer of any
relevant documentation to the tribe.
(5) The family has been referred to CYFD
for family assessment and CYFD has closed the case, and the family is still
declining CARA navigation.
(6) Infant adoption on its own is not a
reason to close a CARA case. The infant
could still benefit from the family infant toddler (FIT) program and home
visiting. Navigators should attempt to
engage with the family but may close the case based on family request. Services may be provided again at family
request.
[8.3.2.12 NMAC - N, 7/1/2026]
8.3.2.13 REFERRAL
TO CYFD FOR FAMILY ASSESSMENT:
A. When a family is demonstrating
conditions that create reasonable suspicion that an infant is an abused or
neglected child, or at risk of impending danger, then the provider or CARA navigator
shall contact CYFD SCI to request a safety assessment.
B. When a family is not compliant with
the POSC, the provider or CARA navigator shall contact CYFD family services
division to request a family assessment.
C. Based on the results of the family
assessment, CYFD may offer or provide referrals for counseling, treatment, or
other services aimed at addressing the underlying causative factors that may
jeopardize the safety or well-being of the child. The child's parents, relatives, guardians,
custodians or caregivers may choose to accept or decline any service or program
offered subsequent to the family assessment; provided that if the child's
parents, relatives, guardians, custodians or caregivers decline those services
or programs, and the CYFD determines that those services or programs are
necessary to address concerns of impending danger to the child, the CYFD shall
proceed with an investigation.
D. If CYFD does not assume custody
following screening or investigation, the facility, MCO, and navigator
responsibilities under 8.3.2.10 through 8.3.2.12 NMAC remain in effect until
navigation is closed under Subsection F of 8.3.2.12 NMAC.
E. CYFD referral and investigation
provisions do not apply to Indian children over whom a tribe exercises
exclusive jurisdiction. In this instance, the CARA navigator program shall
communicate with the tribal child welfare systems as the receiving entity for
any concerns arising under the CARA program.
F. Birthing facilities remain required
to report suspected abuse, neglect, exploitation, or potential impending
danger, to CYFD via SCI prior to discharge.
[8.3.2.13 NMAC - N, 7/1/2026]
8.3.2.14 TRAINING
REQUIREMENTS:
A. HCA will provide training to birthing
facilities and medical staff on SBIRT.
B. HCA or its contractor shall provide
training to providers on evidence-based assessment tools to evaluate infants
born exposed to substances, creation of the POSC, and CARA program
requirements.
C. Birthing facilities and clinics that
perform perinatal visits are required to ensure staff
that interface directly with birthing people and infants have the necessary
training.
D. FIT and home visiting staff shall be
trained in CARA program requirements.
E. CARA program training shall include
how to comply with ICWA and IFPA.
[8.3.2.14 NMAC - N, 7/1/2026]
8.3.2.15 DATA
AND REPORTING REQUIREMENTS: The HCA shall be responsible for collecting
data entered by hospitals, birthing facilities, health care providers and CARA
navigators in the CARA supports system portal to meet federal and state
reporting requirements, including the following from prenatal care offices,
birthing facilities, and the CARA navigation program. All data collection and reporting under this
section shall comply with applicable federal and state privacy and
confidentiality laws, including HIPAA and 42 C.F.R. Part 2, as applicable. Data sharing shall be limited to the minimum
necessary and require informed consent, except where otherwise required by law.
Data collected will include:
A. The primary substance(s) the infant
was exposed to.
B. The services that infants and
families were referred to.
C. The availability and uptake of the
services.
D. Whether an infant or an infant’s
family was subsequently reported to CYFD.
E. Disaggregated demographic and
geographic data.
F. Data will be shared with MCH
epidemiology, family health bureau, and department of health for
epidemiological analysis.
G. Data shall be shared with CYFD for
CAPTA reporting.
H. Tribes will be provided with access
to de-identified aggregate data concerning their enrolled members.
[8.3.2.15 NMAC - N, 7/1/2026]
8.3.2.16 TRIBAL
SOVEREIGNTY: Tribal Nations have the authority to develop
and administer culturally appropriate POSC for their members. Tribal consent is required before data
concerning tribal members is shared with state agencies beyond those directly
involved in the child’s care.
[8.3.2.16 NMAC - N, 7/1/2026]
History of 8.3.2.16 NMAC: [RESERVED]