The Department of Human Services has the legal authority to conduct an assessment of child abuse when it is alleged that:
A child is defined in Iowa Code section 232.68 as any person under the age of 18 years.
The victim of child abuse is a person under the age of 18 who has suffered one or more of the categories of child abuse as defined in Iowa law listed above.
A perpetrator of child abuse must be a person responsible for the care of a child. A person responsible for the care of a child is defined in Iowa Code section 232.68 as:
A person who assumes responsibility for the care or supervision of the child may assume such responsibility through verbal or written agreement, or implicitly through the willing assumption of the caretaking role.
Perpetrators of child abuse come from all walks of life, races, religions, and nationalities. They come from all professions and represent all levels of intelligence and standards of living. There is no single social stratum free from incidents of child abuse.
Abusive parents may show disregard for the child’s own needs, limited abilities, and feelings. Many abusive parents believe that children exist to satisfy parental needs and that the child’s needs are unimportant. Children who don’t satisfy the parent’s needs may become victims of child abuse.
Sexual abusers may have deviant personality traits and behaviors that can result in sexual contact with a child. Sexual abuse perpetrators sometimes use threats, bribery, coercion, or force to engage a child in sexual activity. They violate the trust that a child inherently places in them for care and protection, and exploit the power and authority of their position as a trusted caretaker in order to misuse a child sexually. Often the child is threatened or warned “not to tell,” creating a conspiracy of silence about the abuse.
Normally teachers are not considered caretakers in the teaching and supervising of children. If there is an accusation of child abuse (physical abuse, sexual abuse, or child prostitution) by an employee in the school district, every school district will have policies and procedures in place that they will follow.
Iowa Code section 280.17 requires that
[t]he board of directors of a school district and the authorities in charge of a nonpublic school shall prescribe procedures, in accordance with the guidelines contained in the model policy developed by the department of education in consultation with the department of human services, and adopted by the department of education pursuant to chapter 17A , for the handling of reports of child abuse, as defined in section 232.68, subsection 2, paragraph “a” , subparagraph (1), (3), or (5), alleged to have been committed by an employee or agent of the public or nonpublic school.
The jurisdiction established by Iowa Administrative Code 281–102.3 is that “To constitute a violation of these rules, acts of the school employee must be alleged to have occurred on school grounds, on school time, on a school-sponsored activity, or in a school-related context.”
There are times when an educator may be in the role of a caretaker and outside the jurisdiction of the school. For example, a teacher could be considered a caretaker if the teacher is responsible for supervising a child on an overnight trip.
The Department of Human Services will review reports of child abuse alleged to have been committed by an employee or agent of a public or nonpublic school to determine if a joint assessment with school investigative personnel is appropriate. Where jurisdiction is unclear or there are other extenuating circumstances, DHS may initiate an assessment.
Children are sometimes caretakers for other children and may be responsible for abusing a child in their care. Children may be in a caretaker role, for example, as a babysitter. An adult caretaker may be considered responsible if they delegated care responsibilities to an inappropriate minor caregiver.
A mandatory reporter who suspects that abuse has occurred when one child is caring for another is required by law to make a child abuse report; DHS will then determine if any action should be taken.
Physical abuse is defined as any non-accidental physical injury, or injury that is at variance with the history given of it, suffered by a child as the result of the acts or omissions of a person responsible for the care of the child.
Common indicators could include unusual or unexplained burns, bruises, or fractures. Health services personnel should be especially alert to cases of child abuse where inconsistent histories are presented. Inconsistent histories can take the form of an explanation that does not fit the degree or type of injury to the child, or where the story or explanation of the injury changes over time.
Some indicators of child abuse are not visible on the child’s body. Many times there are no physical indicators of abuse. A child’s behavior can change as a result of abuse. Health services personnel need to be alert to possible behavioral indicators of abuse and if they believe those to be present they are required to make a report. Behavioral indicators include behaviors such as:
Mental injury is defined as any mental injury to a child’s intellectual or psychological capacity as evidenced by an observable and substantial impairment in the child’s ability to function within the child’s normal range of performance and behavior as the result of the acts or omissions of a person responsible for the care of the child, if the impairment is diagnosed and confirmed by a licensed physician or qualified mental health professional as defined in Iowa Code section 622.10.
Examples of mental injury may include:
Sexual abuse is defined as the commission of a sexual offense with or to a child, pursuant to Iowa Code Chapter 709, Iowa Code section 726.2, or Iowa Code section 728.12, subsection 1, as a result of the acts or omissions of the person responsible for the care of the child.
Notwithstanding Iowa Code section 702.5, the commission of a sexual offense under this paragraph includes any sexual offense referred to in this paragraph with or to a person under the age of 18 years.
There are several subcategories of sexual abuse:
Behavioral indicators of sexual abuse could include things such as excessive knowledge of sexual matters beyond normal developmental age, or seductiveness. Physical indicators of sexual abuse could include things such as bruised or bleeding genitalia, venereal disease, or even pregnancy.
Human trafficking is a modern-day form of slavery, and is a felony under Iowa law. Oftentimes, victims pay to be illegally transported into the United States only to find themselves in the servitude of traffickers. Traffickers force many victims into prostitution, involuntary labor, and other forms of enslavement to repay debts, which are often “entry fees” into the United States (Iowa DOJ, 2018).
According to the U.S. Department of Health and Human Services, after drug dealing, human trafficking is tied with arms dealing as the second-largest criminal industry in the world, generating about $32 billion each year. Many human trafficking victims are children. According to a study of U.S. Department of Justice human trafficking task force cases, 83 percent of sex trafficking victims identified in the United States were U.S. citizens. The average age that U.S. citizens are first used for commercial sex is 12–14 (Iowa DOJ, 2018).
Any child under the age of 18 who is manipulated or forced to engage in sex acts for money (or for anything of value) is a victim of sex trafficking. Severe forms of human trafficking include sex trafficking in which a commercial sex act* is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age.
*Commercial sex act: any sex act in which anything of value is given to or received by any person.
When a child under 18 years of age is recruited, enticed, harbored, transported, provided, obtained, patronized, solicited, or maintained to perform a commercial sex act, proving force, fraud, or coercion is not necessary for the offense to be prosecuted as human trafficking. There are no exceptions to this rule: no cultural or socioeconomic rationalizations alter the fact that children who are exploited in prostitution are trafficking victims (USDOS, 2017).
The use of children in commercial sex is prohibited under U.S. law and by statute in most countries. Sex trafficking has devastating effects on children, causing long-lasting physical and psychological trauma, disease (including HIV/AIDS), drug addiction, unwanted pregnancy, malnutrition, social ostracism, and even death (USDOS, 2017).
Recognizing warning signs and key indicators for human trafficking of young people is the first step in identifying victims. Healthcare providers must be aware of these warning signs in boys and girls under that age of 18:
Denial of critical care is defined as the failure on the part of a person responsible for the care of a child to provide for the adequate food, shelter, clothing, medical or mental health treatment, supervision, or other care necessary for the child’s health and welfare when financially able to do so or when offered financial or other reasonable means to do so.
Did You Know. . .
What most people think of as an issue of neglect is covered under the child abuse category of “denial of critical care.”
A parent or guardian legitimately practicing religious beliefs who does not provide specified medical treatment for a child for that reason alone shall not be considered to be abusing the child. However, this does not preclude a court from ordering that medical service be provided to the child where the child’s health requires it.
Denial of critical care includes the following eight sub-categories:
This definition includes cruel and undue confinement of a child and the dangerous operation of a motor vehicle when the person responsible for the care of the child is driving recklessly or driving while intoxicated with the child in the vehicle.
This subcategory also includes:
Child prostitution is defined as the acts or omissions of a person responsible for the care of a child which allow, permit, or encourage the child to engage in acts prohibited pursuant to Iowa Code section 725.1. Notwithstanding Iowa Code section 702.5, acts or omissions under this paragraph include an act or omission referred to in this paragraph with or to a person under the age of 18 years.
Did You Know. . .
Prostitution is defined as a person who sells or offers for sale the person’s services as a partner in a sex act, or who purchases or offers to purchase such services.
Presence of illegal drugs is defined as occurring when an illegal drug is present in a child’s body as a direct and foreseeable consequence of the acts or omissions of the person responsible for the care of the child.
Iowa Code section 232.77, subsection 2 states:
If a health practitioner discovers in a child physical or behavioral symptoms of the effects of exposure to cocaine, heroin, amphetamine, methamphetamine, or other illegal drugs, or combinations or derivatives thereof, which were not prescribed by a health practitioner, or if the health practitioner has determined through examination of the natural mother of the child that the child was exposed in utero, the health practitioner may perform or cause to be performed a medically relevant test, as defined in section 232.73, on the child. The practitioner shall report any positive results of such a test on the child to the department. The department shall begin an assessment pursuant to section 232.71B upon receipt of such a report. A positive test result obtained prior to the birth of a child shall not be used for the criminal prosecution of a parent for acts and omissions resulting in intrauterine exposure of the child to an illegal drug.
Illegal drugs are defined as cocaine, heroin, amphetamine, methamphetamine, other illegal drugs (including marijuana), or combinations or derivatives of illegal drugs that were not prescribed by a health practitioner.
As of July 1, 2017, healthcare providers involved in the delivery or care of an infant affected by any substance abuse or withdrawal symptoms resulting from prenatal drug exposure or Fetal Alcohol Spectrum Disorder will be required to notify the department via the Child Abuse Hotline at 1800 362-2178. Prior to this, only infants born positive for an illegal substance in the child’s body were required to be reported.
This change in Iowa law is the result of new federal legislation. Public Law 114-198, the Comprehensive Addiction and Recovery Act of 2016 (CARA) was passed on July 22, 2016. The intent of this legislation is to address the problem of opioid addiction and to assist states in handling infants born with a substance abuse disorder.
The Iowa Department of Human Services has implemented policies and procedures to address the needs of these infants and their families. When a Child in Need of Assistance assessment is initiated, the DHS worker will consult with the healthcare provider to confirm that the infant is affected by substance abuse, withdrawal symptoms, or Fetal Alcohol Spectrum Disorder. Once confirmed, a Safe Plan of Care will be developed. The healthcare provider will be asked to review the plan and agree that the concerns and needs of the child and family have been identified and addressed.
If DHS is notified by a health practitioner that an infant is substance-affected and additional information is provided that constitutes a child abuse allegation, the department shall commence a Child Abuse Assessment rather than a Child in Need of Assistance assessment. A Safe Plan of Care will be developed as previously indicated.
Examples of situations that may result in a determination of this type of abuse:
Manufacturing or possession of a dangerous substance is defined in Iowa Code section 232.2, subsection 6, paragraph p, as occurring when the person responsible for the care of a child: unlawfully manufactures a dangerous substance in the presence of a child, knowingly allows such manufacture by another person in the presence of a child, or in the presence of a child possesses a product containing ephedrine, its salts, optical isomers, salts of optical isomers, or pseudoephedrine, its salts, optical isomers, salts of optical isomers, with the intent to use the product as a precursor or an intermediary to a dangerous substance.
For the purposes of this definition, in the presence of a child means the manufacture or possession occurred:
Iowa Code section 232.2, subsection 6, paragraph p, defines dangerous substance as:
Note: DHS must report this type of allegation to law enforcement, as this is a criminal act.
Bestiality in the presence of a minor is defined as the commission of a sex act with an animal in the presence of a minor, as defined in Iowa Code section 717C.1, by a person who resides in a home with a child, as the result of the acts or omissions of a person responsible for the care of the child. DHS must report this type of allegation to law enforcement, as this is a criminal act.
It is child abuse if a caretaker knowingly allows unsupervised access to a child by a registered sex offender or allows a registered sex offender to have custody or control of a child up to age 14 or a child up to age 18 if the child has a mental or physical disability. The exceptions are if the registered sex offender is the caretaker’s spouse or is a minor child of the caretaker. DHS must report this type of allegation to law enforcement, as this is a criminal act under child endangerment.
This type of abuse is defined as a caretaker knowingly allowing a child access to obscene material, exhibiting obscene material to a child, or disseminating obscene material to a child, as defined in Iowa Code Section 728.1.