What are my responsibilities 10/16/14 MANDATED CHILD ABUSE REPORTING © 2013 Santa Clara County Public Health Department The Public Health Department is owned and operated by the County of Santa Clara Rhoda Blankenship Public Health Nurse Manager County of Santa Clara Public Health Department

Objectives for today  Mandated Reporter responsibility  Clarity of Documentation  Working with a Multidisciplinary Team 10/16/14 2

 HISTORY OF CHILD MALTREATMENT  In 1874, New York church workers found a young child, Mary Ellen, chained to her bed and with evidence of having been repeatedly beaten. At the time no laws protected children from abuse, but laws forbidding cruelty to animals existed. Using the animal protection laws, the church workers were able to remove Mary Ellen. 3

Risk Factors for Families  Poverty  Poor communication  High stress  Little ability to cope with stress  Violence in the family.  Parental expectations of emotional support from the child  Strong belief in the use of physical punishment. 10/16/14 4

Risk factors for Parents  Immaturity  Isolation  Substance abuse  Childhood experience of abuse.  Negative perceptions of the child  Unrealistic expectations of the child.  Poor ability to handle stress. 10/16/14 5

Risk factors for Children  Premature birth  Colic  Developmental delay  Illness  Being different from parent’s expectations  Challenging temperament  Reminds parent of someone he or she dislikes  Being unwanted by parent  Very young age 10/16/14 6

Neighborhood/communities risk factors 10/16/14 7

Protective Factors  Family relationships that meet each member’s needs for nurturance and individual growth.  Skills and resources for coping with stress. 10/16/14 8

Protective Factors 10/16/14 9  Social, emotional, and practical support  Access to needed information.  Communities that support families

Family members can develop 10/16/14 10  When they know they can rely on others for care and support and that they can pursue their individual interests and goals.

Families need 10/16/14 11  Friends, neighbors, and relatives, as well as service providers, for practical help, information, or a “listening ear,” they are less isolated and the risk of abuse decreases.

Why am I telling you all this? 10/16/14 12  Because these are the things that the DFCS SW will be looking at.  What are the protective factors that this family has.  What are their strengths and weaknesses.  When they go before a Judge they need to have a good reason for removal.

You are a Mandated Reporter All Registered Nurses are required by law to make a report to their local Child Protective Services agency if they have a reasonable suspicion that a child in their care has been abused, neglected or the potential of this happening.  Remember you don’t investigate, only the CPS SW will do that. Yours is a suspicion, not a fact. 10/16/14 13

You must report it… 10/16/14 14 It may help to talk to other staff members to see what they think.  If you have reasonable suspicion of abuse, you must report  Make a report by phoning the local CPS agency.  You will need to fill out a form and send it to CPS within 36 hours.  Tip: fill out form before you call. You will better prepared to answer questions.

Documentation 10/16/14 15  What did you see?  What did you hear?  What did you observe?  Helps the care team to make decisions.  Chart like you are going to court.  Remember your documentation is a legal document.

Documentation 10/16/14 16  Mother stated  Father stated  Maternal/Paternal Grandparents stated  Foster parents stated  Probation Officer stated  SW stated

Documentation 10/16/14 17  Family member did not come to pick up MOB until 3 hours after they were called.  Family member states that MOB needs to find another place to live since she now has an infant.  MOB does not come to visit NB.  Nurse observed MOB not making eye contact with infant.  Nurse observed MOB not holding infant, even when encouraged by RN.  FOB was instructed on proper holding of the infant, but declined to hold infant properly.

Documentation 10/16/14 18  Did not arrive for scheduled classes, CPR, etc.  Did spend the night before discharge.  Lots of excuses as to why……  Hearing voices…  Arrived to visit infant under the influence of drugs or alcohol.

Documentation 10/16/14 19 CHART LIKE YOU ARE GOING TO COURT YOU NEVER KNOW WHO IS GOING TO READ YOUR CHART YOUR DOCUMENTATION PAINTS A PICTURE

Team Work 10/16/14 20  Multidisciplinary Team provides for the infants in the NICU  Is everyone observing the same thing?  Does everyone have access to the parents that you do?  Maybe the family only comes to visit at night.

Team Work 10/16/14 21  Have conversations with your team members. Share your concerns.  Is there a protocol regarding only the MSW makes the CPS report?

Remember 10/16/14 22  You are a mandated reporter  Your documentation is vital to the care of the infant…its’ not just medical.  Communicate with your Team. Your documentation provides this even if you aren’t there.