DCF changes fentanyl testing policy after baby’s fatal overdose
The death of a New Haven baby last June has prompted the state Department of Children and Families to change its policies regarding fentanyl testing for parents acting as caretakers for young children under the agency’s purview, officials said Wednesday.
Alexander Polino tested positive for fentanyl several times while she was caring for her 10month-old son Marcello Meadows, according to an arrest warrant and a report issued this month on the baby’s death.
But DCF closed its case with the family in early June 2023, three weeks before Meadows died of fentanyl, Xylazine and cocaine poisoning, the documents said.
“As a direct result of Marcello’s death,” DCF has implemented new tests for fentanyl use that show accurate results immediately and a new testing plan for its caseworkers and contracted service providers, agency Deputy Commissioner Michael Williams said Wednesday during a meeting of the state’s Child Fatality Review Panel, which discussed Meadows’ death.
To help combat the opioid crisis, DCF launched a pilot program Wednesday at its Norwich and Danbury offices to provide naloxone, a drug that can stop an opioid overdose, with its workers who see families at their homes and within the community. The new fentanyl testing protocol began earlier this month, according to Kris Robles, a clinical behavioral manager for DCF.
“We have to be in a state of ongoing change and ongoing assessment,” Williams said. The agency won’t necessarily be doing the same types of interventions today that it will be doing a year from now, he said.
The naloxone project is an example of the changes required to deal with the opioid crisis, Williams said. A year ago, the agency refused to consider having case managers trained to use naloxone and giving the drug to families, he said.
“We didn’t want it in the office, let alone have anyone carry it,” Williams said after the meeting.
But based on the “mounting number of folks who were dying, we became convinced this was the right thing to do,” Williams said. Training for the workers started Wednesday from a multiagency team that includes employees of the state Department of Mental Health and Addiction Services and the state Department of Health.
The goal of the pilot will be to have workers in the DCF offices in Danbury and Norwich trained in how to use the drug to stop an overdose and also provide naloxone to the families they deal with, Williams said. DCF employees requested that the program start in those locations based on the needs of those communities, he said.
But the push to provide naloxone and greater awareness on fentanyl deaths can’t just rest with families who are involved with DCF, according to Jodi Hill-Lilly, commissioner designate for DCF.
“These messages need to come from everywhere,”
she said. “This is a public health agenda, it’s so critically important that it shouldn’t just be the threat of DCF.”
The report on Meadows’ death issued by state Child Advocate Sarah Eagan, who co-chairs the CFRP, concluded that DCF workers didn’t follow some the of agency’s own new policies in dealing with caregivers of children under 5 who use fentanyl, a drug that can kill a baby with just a few grains.
One of the problems highlighted in Eagan’s report was that no agency or service provider had a routine schedule for testing Meadows’ mother for drug use and some of the tests came back inclusive or were done while Polino was unsupervised.
Eagan also concluded that the agency didn’t
make sure that Meadows was connected with Birth to Three services as an infant who was born suffering from Neonatal Opioid Withdrawal Syndrome. He was the 11th child under the age of 21⁄2 since 2020 to die from a fentanyl overdose, according to Eagan who did a similar report on 1-year-old Kaylee Schubel who also died of fentanyl poisoning while her family was under the purview of DCF.
Schubel’s death sparked DCF to issue new guidelines in August 2022 on what protocols employees should follow to handle families dealing with fentanyl addiction.
But Eagan’s investigation into Meadows’ death indicates that some of the new guidelines weren’t followed, including that staff failed to conduct required home visits in the
weeks after a safety plan was formed and there was no indication a supervisor reviewed how the plan was working every two weeks, the report said.
Eagan is recommending that DCF efforts around safety planning and case supervision should be improved and more closely monitored and that caregivers of small children who are dealing with substance abuse disorder be provided with well-supported in-home services. She also said the state should form a Medicaid and commercial insurance plan for the reimbursement of naloxone, a drug that can stop an opioid overdose.
Some of Eagan’s proposals based on Meadows’ death are being discussed as potential legislation before the Children’s Committee and the Public Health Committee.
“Fentanyl is a dangerous riddle that we have not solved,” Eagan said after the meeting.
Dealing with parents who have substance abuse issues requires a balance, Williams and Hill-Lilly said. The agency looks at whether a parent who is using drugs or alcohol can still feed and dress their child and doesn’t drive impaired with them in the car, Williams said.
But due to the rising fentanyl crisis, child protection services are under a whole different set of strains, Williams said.
“We’re not just talking about a caregiver’s capacity to keep a child safe, we’re talking about keeping a child safe from exposure (to fentanyl),” he said.
Opioid use touches all types of socioeconomic levels, Hill-Lilly said.
“Those with means have the means to have a nanny and to have child care protections in place,” Hill-Lilly said. “We don’t want this to be a narrative where poor people who don’t have the means get their kids taken away unnecessarily.”