Child Abuse Prevention & Treatment Act
Defines the term "child abuse and neglect" as any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical, emotional harm, sexual abuse, exploitation, or act/failure to act that presents an imminent risk
Who is required to report child abuse
Physicians, interns, RN's, chiropractors, social service workers, psychologists, dentists any person in the healthcare setting,.. (pg 202) are required to report, or cause a report to be made, when they have reasonable cause or suspect
What is "Good -Faith" reporting
The person making the report believes the facts reported are true, legally protected
What steps must be made in filing a report of child abuse
Oral report be made immediately, followed by a written report containing: Child's name & address, age, persons responsible for child's care, nature & extent of child's injuries & any other pertinent information
Who is immune from liability
Anyone who reports in good faith, case study: Marks v Tenbrunsel
CASE STUDY: Marks v Tenbrunsel
Patient had been assured anything he disclosed during his treatment sessions would remain confidential, during this time he disclosed he fondled 2 children under age of 12, as a result 2 psychologists made a "good faith" report to Child protective service
Elder Abuse
Any form of mistreatment that results in harm or loss to an older person.
Birth and Deaths
Must be reported by statute
Health Care Quality Improvement Act ( HCQIA) of 1986 (pg 204)
Enacted to improve the quality of medical care by encouraging physicians to participate in peer review & by restricting incompetent physicians ability to move from state to state w/o disclosure of previous performance
National Practitioner Data Bank (NDPB)
Created by Congress as a national repository of information w/ primary purpose of facilitating a comprehensive review of physicians & other health care providers
What department is responsible for data bank implementation
Bureau of Health Professions, Health Resources & Services Administration of the DHHS
How often must Health Care Organizations query the data bank
Every 2 years on the renewal of staff privileges
What diseases of the newborns do Hospitals have to report to Maternal & Child Health Office, part of State Health Department
1. Hemolytic disease of Newborn, (HDN) erythroblastosis; Rh factor
2. Conjunctivitis; Infection of Eye usually from Gonorhea, Syphyillis (Calif., every newborn is treated to prevent)
3. Diarrhea of Newborn; indicative of Intestinal disease
Preventable Heritable Disorders: Health & Safety Code 309 requires newborns to be tested
Newborn Testing is currently required for certain Inheritable Disorders that all lead to some form of retardation
What diseases in the newborn cause degrees of retardation that have to be reported
1. Phenylketonuria- rare condition in which a baby is born without the ability to properly break
down an amino acid (Mandatory reporting)
2. Hypothyroidism- not detected for about 1 month (If discovered, then reportable)
3. Galactosemia- rare inheritable
After birth of baby, what must hospitals obtain?
Informed consent from the parents that a blood specimen will be taken from the newborn for genetic testing
After birth of baby, if parent does not consent to genetic testing what must the hospital obtain
Refusal must be documented by completing "Newborn Screening Test Refusal" form
What is the state's interest in testing Newborns
Concern for newborn
Monetary interest, because the state would be paying a lot of money
After receiving "Newborn Screening Test Refusal" form what 3 forms do you have to document, file
1. Mother's chart
2. Newborn's chart
3. Send to State Depart. of Health Service (genetic testing)
Abused Children: California Penal Code 11165-11174
Requires certain persons, including any "child care custodian", "medical practitioner", or "non medical practitioner" who has knowledge of or suspects has been victim of child abuse has to report. (pg 75, notes)
If you suspect child abuse, what are you required to do
1. Report such suspected instances of child abuse to a "Child Protective Agency" immediately by telephone
2. File a written report within 36 hours
When is Mandatory reporting involving child abuse required
Physical injury, Sexual assault, Willful Cruelty/Unjustifiable punishment, Corporal punishment, Neglect, Abuse in out-of-home care,
Willful Cruelty/Unjustifiable Punishment
Physical, can be Mental suffering
i.e. Tie to bed, keep in closet
Corporal Punishment
Anything that leaves a Mark
Neglect
Severe failure to thrive, Malnourished, general lack of adequate supervision, food, clothing
Abuse in out-of-home care
Foster care, School, Institution or Agency
Discretionary reporting for certain suspected mental or emotional abuse
Often this is by School Teachers reporting at their discretion, Very difficult to prove, unless child directly told
Classifications of persons are required or permitted to report
Mandatory- All persons employed with children Non-mandatory- (Penal code 11166 c) Permits but does not require, i.e. Neighbor
Hospitals- (Penal code 11166 d 11166 e) Allowed to have internal procedure, duty is on Individual! i.e. Nurse suspects abuse, rep
Who do you file child abuse reports to
Police, Sheriff's Department, County Probation Department, or a County Welfare Department (Penal code 1165 (k)) immediately by telephone, and within 36 hours file a written report
Are diagnostic x-rays permitted without parental consent if suspect abuse
(Penal code 11171) You may obtain a "Skeletal" image ONLY, can't use contrast material w/o consent
When are physcian/patient privileges inapplicable
Neither the physician-patient or psychotherapist-patient privilege applies to information reported pursuant to this statute in any court proceeding or administrative hearing. (Penal code 11171)
Who is immune from liability for reporting Abuse
Any person who does so in "good-faith" should not incur personal/civil liability for reporting
Relevant case: June 13, 1999
Felony child abuse conviction, made possible thanks to nurse's documentation.
Child abuse is a "reportable" crime. This means
when a healthcare worker suspects in the course of their duties that a child has been abused, it must be reported. Procedures are
Suspected Dependent Adult/elder/Abuse {Welfare & Institutions code 15630 (a) (1) (2) & 255633 (a) (b)
Physical, Mental, Financial
i.e. Stealing in a convalescent home
Reportable Diseases [ Health & Safety Code 3125] Title 17, California Adminstrative code 2500
Code that Physicians & Hospital administrators require to file Reportable Diseases
Outbreaks or Unusual Diseases: Title 17, Ca admin code 2502 & 2503
Report infectious parasites, tapeworm, & even those not on list
What department do you report diseases to
Department of Health
Lapses of consciousness
Must report anyone over age 14 years of age, i.e. epilepsy, need to be seizure free for a period of time
Certification of Birth [Health & Safety code 10125]
Any live birth occurs in hospital, administrator must register birth, (may delegate to another staff member but must be in writing) with local registrar within 10 days of birth
Injuries by Deadly weapon or Criminal act [Penal code 11160-11161]
Hospitals, physicians, or any other medical staff have to report to law enforcement immediately by and submit written report within 36 hours