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Continuing Education for Health Professionals

IA: Child Abuse, A Guide for Mandatory Reporters

Module 6

Responses by the State of Iowa

On January 1, 2014, the Iowa Department of Human Services (DHS) began using a Differential Response (DR) System to respond to allegations of neglect and abuse. The system uses two pathways: Family Assessment (FA) and Child Abuse Assessments (CAA) for responding to allegations of neglect and abuse (DHS, 2015a).

The DR System did not change the criteria for accepting a report for assessment but changes made to Iowa Administrative Code did affect worker response times. Labeling of perpetrators and victims, and the report conclusion categories for less serious cases once accepted for assessment. Code changes also were made to outline a clear path for reassigning cases from the FA path to the CAA path. The fundamental premise for decisions is that “safety of a child is first and foremost” (DHS, 2015a).

Findings after two years on the DR System “remain promising.” The system is working as designed and outcomes have been positive. Children who receive an FA are not less safe than those receiving a CAA (DHS, 2015a).

The new system was intended to be more family-friendly, flexible, and better able to engage and empower families in making changes to improve child well-being while still keeping children safe (DHS, 2013a). Experience and data for 2014 and 2015 so far suggest that these goals are realistic. Families are making greater use of voluntary services and children remain safe (DHS, 2015a, 2014a, 2014b).

All reports of child abuse received by DHS are immediately subjected to the intake process, and the decision to accept or reject a report of child abuse is made at this stage.

Intake

The purpose of intake is to obtain information to ensure that reports of child abuse meeting the criteria for assessment are accepted and reports that do not meet the legal requirements are appropriately rejected. DHS policy is to accept a report when there is insufficient information to reject it.

The first step in this process is to initiate safeguards for children who are at risk or have been abused. DHS staff will ask questions of the reporter, record necessary information, and discern between significant and extraneous information.

Information gathered at intake includes:

  • The allegation of child abuse
  • The identity and location of the child, parents, or caretakers
  • The safety of and risk to the child
  • The identity and location of the person allegedly responsible for the abuse
  • That person’s access to children
  • Information regarding the mandatory reporter

The supervisor is responsible for ensuring that accurate information is documented.

While it is helpful to be familiar with child abuse definitions to make a report, knowing the definitions and terminology is not essential. DHS will determine the type of abuse being alleged. It may be possible to make reasonable inferences that would cause a report to be accepted for assessment based upon the description of what occurred, so detailed and accurate information is essential.

You may be contacted when:

  • Your initial report is made through a written report of child abuse
  • Any of the information in your initial report is unclear or incomplete
  • Information in your initial report is called into question once the assessment is initiated
  • The written report you submit contains new or different information from that provided in your oral report of child abuse

Reports from Multiple Reporters

When more than one mandatory reporter reasonably suspects abuse involving the same incident, the mandatory reporters may jointly make a written report to DHS.

When more than one reporter separately makes a report of suspected child abuse on the same incident, and the first report is currently being assessed, DHS will advise the subsequent reporters that the report of child abuse they are making has already been accepted as a case.

Accepted Intakes

When your report meets the criteria for assessment, DHS will inform you that the report of child abuse has been accepted as a case within 24 hours of receiving the report. DHS may provide this oral notification at the time that the report is made if the report is accepted immediately. If your report is not accepted immediately because further consultation is required with a supervisor, you will be informed that further consultation is needed before a decision can be made, and someone will be calling you back with the decision.

Rejected Intakes

DHS must obtain sufficient information to be able to determine if a report meets the intake criteria. A supervisor reviews the report and makes the final determination about rejecting the report for assessment. If your report is rejected, DHS will:

  • Contact law enforcement if a child’s safety appears to be in jeopardy
  • Orally notify you that the report has been rejected within 24 hours of receipt
  • Send you a written notice indicating the decision to reject the report within five working days of its receipt, using form 470-3789, Notice of Intake Decision, which includes instructions on what to do if you disagree with the decision
  • Provide a copy of intake information to the county attorney within five working days of its receipt

You will be advised that:

  • The report is being rejected for one or more of the following reasons:
    • The reported victim is not a child.
    • The person alleged to have abused the child is not a caretaker.
    • The reported abuse does not fall within the definition of child abuse.
  • The report will be screened for a possible “child in need of assistance” assessment to determine if juvenile court action is necessary. The family may apply for services through DHS if there is a founded child abuse report or a juvenile court order.
  • You may inform the family of services available in the community.

If you become aware of circumstances where you believe that the child is imminently likely to be abused or neglected, report this to DHS. These may include, but are not limited to, a child born into a family in which:

  • The court has previously adjudicated another child to be a child in need of assistance due to abuse;
  • The court has terminated parental rights to a child; or
  • The parent has relinquished rights with respect to a child due to child abuse.

DHS may seek an ex parte removal order if it appears that the newborn’s immediate removal is necessary to avoid imminent danger to the child’s life or health.

When intake information does not meet the legal definition of child abuse, but a criminal act to a child is alleged, DHS refers the report to the appropriate law enforcement agency. If the intake information alleges sexual abuse of a child by a person who is not a “caretaker,” DHS refers the report to law enforcement verbally and also submits the referral information in writing within 72 hours of receiving the report.

The DHS Intake Unit keeps a copy of intake information for rejected reports of child abuse for three years, then destroys it.

Rejected intake information is not considered “child abuse information.” It is governed by the same provisions of confidentiality as DHS service case records. If a subject of a report requests information about a rejected intake involving the subject, DHS will provide a copy of the rejected intake to the subject, if it is available, after removing the name of the reporter.

If you become aware of new information after your report has been rejected, make a new report to DHS.

Two Pathways

Under the differential response system, accepted reports are then assigned to one of two pathways: Child Abuse Assessment or Family Assessment. In order to determine which is the correct path, DHS uses an Intake Screening Criteria in which the Family Assessment path can be followed only if none of the conditions below are true:

  • The alleged abuse type includes a category other than Denial of Critical Care.
  • The allegation constitutes a 1-hour response or alleges imminent danger, death, or injury to a child.
  • The child has been taken into protective custody as a result of the allegation.
  • There is an open DHS service case on the alleged child victim or any sibling or any other child who resides in the home or in the home of the non-custodial parent if they are the alleged person responsible.
  • The alleged person responsible is not a parent (birth or adoptive), legal guardian, or a member of the child’s household.
  • The child does not live in the home with a parent (birth or adoptive) or legal guardian.
  • There has been TPR (in juvenile court) on the alleged person responsible or any caretaker who resides in the home.
  • There has been prior Confirmed or Founded abuse within the past 6 months which lists any caretaker who resides in the home as the person responsible.
  • It is alleged that a caretaker is selling illegal drugs from the family home.
  • The allegation is failure to thrive or that the caregiver has failed to respond to an infant’s life-threatening condition.
  • The allegation involves an incident for which the caretaker has been charged with felony under chapter 726 of the Iowa Code (DHS, 2014b; IAC, 441—175.24(2)).

Child Abuse Assessment Path

DHS will make a determination regarding abuse—not confirmed, confirmed, or founded—and will determine whether the family is at high, moderate, or low risk of future abuse or neglect.

DHS will open an ongoing service case on all founded assessments, and all confirmed cases assessed as being at high-risk of future abuse or neglect. These families will be eligible to receive DHS case management and the current array of child welfare services.

If an assessment was confirmed and the family is assessed as being at moderate risk of future abuse or neglect or if the assessment was not confirmed but the family is assessed as being at moderate or high risk of future abuse or neglect, the family can be referred to Community Care for further services.

If an assessment was confirmed or not confirmed and the family is assessed as being at low risk of future abuse or neglect, information and referral will be provided if needed.

If the intervention of the Juvenile Court is needed—regardless of abuse finding or risk level—DHS will request a Child in Need of Assistance (see Iowa Code section 232.2, subsection 6) petition (DHS, 2013d).

Determination Whether Abuse Occurred

After gathering necessary information from observations, interviews, and documentation, and after assessing the credibility of subjects of the report, collateral contacts and information, DHS must determine whether abuse occurred. Each category or subcategory of child abuse requires that specific criteria be met in order to conclude that abuse occurred.

This determination is based on a “preponderance” of credible evidence, defined as greater than 50% of the credible evidence gathered. The child protective worker must make one of the following conclusions regarding a report of child abuse:

  • Not confirmed: Based on the credible evidence gathered, DHS determines that there is not a preponderance of available credible evidence that abuse did occur.
  • Confirmed (but not placed on the Child Abuse Registry): Based on a preponderance of all of the credible evidence available to DHS, the allegation of abuse is confirmed; however, the abuse will not be placed on the Child Abuse Registry.
  • Founded: Based on a preponderance of credible evidence available to DHS, the allegation of abuse is confirmed and it is the type of abuse that requires placement on the Child Abuse Registry.

Family Assessment Path

The risk assessment completed during the course of the Family Assessment will determine whether the family is at high, moderate, or low risk of future abuse or neglect.

Any family assessed as being at moderate or high risk of future abuse or neglect is eligible for Community Care services. A family assessed as being at low risk of future abuse or neglect will be provided information and referral if needed.

If the intervention of the Juvenile Court is needed—regardless of risk level—DHS will request a Child in Need of Assistance (see Iowa Code section 232.2, subsection 6) petition (DHS, 2013d).

The figures below show the major steps on both pathways and the outcome and service provisions of each.

 

Iowa’s Differential Response System—
Two Paths for Accepted Abuse Referrals

For a full size image of this diagram, please reference the source document at http://dhs.iowa.gov/sites/default/files/DR_one_pager.pdf.

image: diagram of paths through Iowa differential response system

Source: DHS, 2013a.

 

State of Iowa Differential Response
Assessment Outcome and Service Provision
Effective 1/1/14

image: diagram of assessment outcome and service provision

*Family Safety Risk and Permanency

Source: DHS, 2013d.

 

Removal of a Child

Iowa laws provide for a child to be placed in protective custody in various situations. DHS does not have a statutory authority to simply remove a child from a parent or other caretaker. The procedures for a child to be placed in protective custody are outlined in Iowa Code sections 232.78 through 232.79A.

Assessment workers do not have the legal authority to remove children from their home without a court order or parental consent. Only a peace officer or a physician treating a child may remove a child without a court order if the child’s immediate removal is necessary to avoid imminent danger to the child’s life or health.

Juvenile Court Hearings

Juvenile court hearings are held when children are removed from their parent’s custody or when treatment or DHS supervision of abused or neglected children is necessary because the parents are unwilling or unable to provide such treatment or supervision.

Parents are notified immediately if their child is placed in other care. A petition for a hearing must be filed with the juvenile court within 3 days of the removal of a child from a parent’s care. A juvenile court hearing is held promptly in order to review the need for continued protection of the child through shelter care. Parents are provided the opportunity at the shelter care hearing to present evidence that their child can be returned home without danger of injury or harm.

The court ensures that the parent’s and the children’s rights will be protected. An attorney will be appointed to represent the child’s best interest in these cases. The attorney representing the child is called the guardian ad litem. The court may also appoint a court-appointed special advocate (CASA) to assist in informing the court regarding child’s progress and recommendations.

The parents have a right to legal counsel. If they cannot afford an attorney, the court will appoint one.

Additional hearings are held if the court determines that the child needs its protection. At each hearing, the court reviews the efforts of the parents to remedy problems and the services arranged for or provided by DHS to help the parents and children.

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