IA: Child Abuse, A Guide for Mandatory Reporters

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This course has been approved by the Iowa Department of Public Health, approval #2907.

Course Summary

Identifies mandatory reporters of child abuse in Iowa and summarizes the procedures for making such a report. Defines child abuse under Iowa law and reviews in detail the procedures of the Iowa Department of Health Services (DHS).

ATrain Education, Inc. is an approved provider by the American Occupational Therapy Association. The following course information applies to occupational therapy professionals:

  • Target Audience: Occupational Therapists, OTAs
  • Instructional Level: Intermediate
  • Content Focus: Category 1—Domain of OT, Client Factors; Category 2—Occupational Therapy Process, Outcomes

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Accredited status does not imply endorsement by ATrain Education Inc. or by the American Nurses Credentialing Center or any other accrediting agency of any products discussed or displayed in this course. The planners and authors of this course have declared no conflict of interest and all information is provided fairly and without bias.

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No commercial support was received for this activity.

This course will be reviewed every two years. It will be updated or discontinued on December 1, 2020.

Criteria for Successful Completions
80% or higher on the post test, a completed evaluation form, and payment where required. No partial credit will be awarded.

Accreditations

Course Objectives

When you finish this course you will be able to:

Legal Response to Child Abuse

Child abuse is not a new phenomenon. The abuse and neglect of children has been documented for more than two thousand years. However, attempts to prevent child abuse are relatively new.

The first documented legal response to child abuse in the United States occurred in 1874. The New York Society for the Prevention of Cruelty to Animals pleaded in court to have an 8-year-old child removed from her abusive and neglectful environment. Since there were no child abuse laws, the society argued that the child was, in fact, an animal, and should be provided the same protection as other animals. During the last few decades of the nineteenth century, societies to protect children from cruelty were formed in many states.

The next movement to protect children came as the result of several pediatricians publishing articles about children suffering multiple fractures and brain injuries at the hands of their caretakers. In 1961, C. Henry Kempe, a physician who was then president of the American Academy of Pediatrics, held a conference on the “battered child syndrome,” in which he outlined a “duty” to the child to prevent “repetition of trauma.” The Battered Child Syndrome Conference resulted in many states passing laws to protect children from physical abuse.

Child abuse is now recognized as a problem of epidemic proportions. Child abuse has serious consequences that may remain as indelible pain throughout the victim’s lifetime. The violence and negligence of parents and caretakers serve as a model for children as they grow up. The child victims of today, without protection and treatment, may become the child abusers of tomorrow.

As with any social issue, child abuse is a problem for the entire community. Achieving the goals of protective services requires the coordination of many resources. Each professional group and agency involved with a family assumes responsibility for specific elements of the child protective service process.

National Response

Nationally, the 2015 Child Maltreatment Report, published by the U.S. Department of Health and Human Services Children’s (USDHHS) Bureau, indicates that an estimated 4 million referrals alleging child abuse and neglect involving approximately 7.2 million children were made to state child protective service agencies that year, a 15.5% increase since 2011. Approximately 58% of referrals were accepted for investigation or assessment (ie, screened in) (USDHHS, 2015).

Approximately 21.4% of the investigations and assessments confirmed child abuse. There were an estimated 683,000 victims of child abuse nationwide. The rate of victimization was 9.2 per 1,000 children. The highest victimization rates were for the birth to age 1 group (24.2 per 1,000 children). Boys accounted for 48.6% of victims and girls 50.9% (USDHHS, 2015).

National studies continue to indicate that only about one-third of maltreated children are reported to child protection agencies. Significant numbers of victims remain unidentified and thus without protection and treatment.

In 1985 the U.S. Surgeon General declared family violence to be a national epidemic. At that time, an estimated 3.3 million children were exposed to violence by a family member against a mother or female caretaker. The U.S. Advisory Board on Child Abuse and Neglect found domestic violence to be the single major precursor to child abuse and neglect fatalities in the United States.

 

Did You Know. . .

Child abuse is 15 times more likely to occur in homes where adult domestic violence is present.

 

According to the Effective Intervention in Domestic Violence and Child Maltreatment Cases: Guidelines for Policy and Practice, published by the National Council of Juvenile and Family Court Judges in 1999, “Domestic violence perpetrators do not victimize only adults.” Known as The Greenbook, this publication fostered demonstration sites and is still in use today. Recent reviews of more than two decades of studies have revealed that in families where women are abused many of their children are also maltreated (IDJ, 2016, 1999).

According to the Iowa Attorney General’s Office, Crime Victim Assistance Division, from January 1995 through April 2016, 279 Iowans were killed in domestic abuse homicides. During that period:

  • 190 women were killed by their spouse, former spouse, boyfriend, or intimate partner
  • 35 men were killed by their partners
  • 54 bystanders were killed
  • 28 children were killed in domestic abuse murders
  • 200 minor children survived the murder of their mother or father
  • 84 children were present at the scene of the murder (IDJ, 2016)

Although many adults believe they have protected their child from exposure to domestic violence, 80% to 90% of children in those homes can give detailed descriptions of the violence experienced in their families (Doyne et al., 1999). The U.S. Advisory Board on Child Abuse suggests that domestic violence may be the single major precursor to child fatalities in this country.

Varying by samples selected and types of data gathered, the majority of these studies have found that a substantial proportion, ranging from 30% to 60%, of battered mothers’ children also are maltreated. Children who are abused physically or sexually or who witness violence tend to exhibit more developmental, cognitive, emotional, and social behavior problems—including depression and increased aggression—than other children (Edelson, 2011; FWV, 2013).

Iowa Response

Iowa’s child abuse reporting, assessment, and rehabilitation law, Iowa Code (IC) sections 232.67–232.75, was initially enacted in 1978 and has been amended numerous times since. Changes to the law can be made in any legislative session and have occurred in six of the last eight legislatures. An important change made in 2016 was the expansion of the definition of child abuse to include child sex trafficking and a modification of the sexual abuse code to include acts or omissions not only by a caretaker but also by “a person who resides in a home with the child” (Coreless, 2016; IC section 232.68(2)(a)(3) & (11); INAHT, 2016, 2016a).

The intent of the law is to identify children who are victims of abuse. The law also provides for a professional assessment to determine if abuse has occurred. Accompanying the assessment are protective services designed to protect, treat, and prevent further maltreatment.

The purpose of the Iowa law is to “provide the greatest possible protection to victims or potential victims of abuse through encouraging the increased reporting of suspected cases of abuse, ensuring the thorough and prompt assessment of these reports, and providing rehabilitative services, where appropriate and whenever possible, to abused children and their families, which will stabilize the home environment so that the family can remain intact without further danger to the child” (IC 232.67).

According to Iowa statute (IC 232.70), the Department of Human Services (DHS) has the responsibility to receive and assess reports of suspected child abuse and neglect.

In calendar year 2015, DHS accepted 24,298 reports for assessment. Family assessments were completed for 7,469 and child abuse assessments for the remaining 16,829. After completing the child abuse assessments, DHS found 10,787 (64%) to be unconfirmed, 1,231 (7.3%) confirmed, and 4,811 (28.6%) founded. These data reflect only the number of reports or assessments. Looking at unique children, the total reports covered 29,695 unique children, with the confirmed reports covering 1,408 and founded 6,890.

In 2014 the total number of reports accepted for assessment was 23,562 covering 28,332 unique children, and in 2013 26,129 reports covered 30,801 unique children (DHS, 2015).

 

Source: DHS, 2015.

Iowa Confirmed Child Abuse in Calendar Years 2013–2015

 

Percentage of total confirmed or founded abuse

Types of abuse

2013

2014

2015

Denial of critical care

78

.4%

70

.0%

72

.0%

Physical abuse

9

.0%

12

.4%

11

.4%

Presence of illegal drugs in child’s system

6

.4%

8

.5%

9

.4%

Sexual abuse

3

.9%

6

.6%

4

.8%

Allows access by registered sex offender

1

.0%

1

.1%

1

.3%

Exposure to manufacturing of meth

0

.9%

1

.1%

0

.6%

Mental injury

0

.2%

0

.2%

0

.2%

Other

0

.0%

0

.0%

0

.0%

 

DHS works closely with physicians, nurses, educators, mental health practitioners, law enforcement agencies, and the judiciary. These parties are involved in the identification, reporting, assessment, and treatment of cases of child maltreatment. Ultimately, children can be kept safer from abuse and neglect through increased community ownership, responsibility, and involvement. One entity alone (whether legislators, DHS, physicians, educators, or local law enforcement) cannot eliminate child abuse. The safety of children depends upon how well communities support families, organize basic systems, and make inclusive decisions about available resources.

Partnerships that involve parents, neighbors, and grassroots community groups, in addition to public agencies and non-profit organizations, create community ownership, responsibility, and involvement. The vision of partnerships has evolved with the realization that one size does not fit all. Through partnerships, citizens define a community’s needs, and services can be tailored to the particular needs and strengths of individual communities.

The child abuse reporting law is only one type of Iowa statute designed to deal with child abuse. Juvenile justice laws authorize the court to provide protection for children through supervision in their own homes or in substitute care. Criminal laws are separate from the child abuse reporting and juvenile justice laws. Criminal laws provide for prosecution of alleged perpetrators in cases where a criminal act has been committed.

Am I a Mandatory Reporter of Child Abuse?

Iowa law defines classes of people who must make a report of child abuse within 24 hours when they reasonably believe a child has suffered abuse. These mandatory reporters are professionals who have frequent contact with children, generally in one of six disciplines:

  • Health
  • Education
  • Childcare
  • Mental health
  • Law enforcement
  • Social work

Included as mandatory reporters are all licensed physicians and surgeons, physician assistants, dentists, licensed dental hygienists, optometrists, podiatrists, chiropractors, and residents or interns in any of these professions; and registered nurses, licensed practical nurses, basic and advanced emergency medical care providers.

Also included are any of the following persons who, in the scope of professional practice or in their employment responsibilities, examines, attends, counsels, or treats a child:

  • Social worker
  • Employee or operator of a public or private healthcare facility as defined in Iowa Code section 135C.1
  • Certified psychologist
  • Licensed school employee, certified para-educator, or holder of a coaching authorization issued under Iowa Code section 272.31, or an instructor employed by a community college
  • Employee or operator of a licensed childcare center, registered child development home, Head Start program, Family Development and Self-Sufficiency Grant program under Iowa Code section 216A.107, or Healthy Opportunities for Parents to Experience Success—Healthy Families Iowa program under Iowa Code section 135.106
  • Employee or operator of a substance abuse program or facility licensed under Iowa Code Chapter 125
  • Employee of an institution operated by DHS listed in Iowa Code section 218.1
  • Employee or operator of a juvenile detention or juvenile shelter care facility approved under Iowa Code section 232.142
  • Employee or operator of a foster care facility licensed or approved under Iowa Code Chapter 237
  • Employee or operator of a mental health center
  • Peace officer
  • Counselor or mental health professional
  • Employee or operator of a provider of services to children funded under a federally approved medical assistance home- and community-based services waiver

The employer or supervisor of a person who is a mandatory reporter shall not apply a policy, work rule, or other requirement that interferes with the person making a report of child abuse.

Clergy members are not considered to be mandatory reporters unless they are functioning as social workers, counselors, or another role described as a mandatory reporter. If a member of clergy provides counseling services to a child, and the child discloses an abuse allegation, then the clergy member is mandated to report as a counselor. (The counseling is provided to a child during the scope of the reporter’s profession as a counselor, not clergy.)

Healthcare Workers

Health service professionals play many roles in the recognition and treatment of child abuse, including the recognition of the abuse, reporting the suspected abuse, crisis intervention, and long-term treatment. Health services personnel are often the first line of defense in the early detection of child abuse. Most health professionals who treat children are required to be mandatory reporters of child abuse.

Healthcare professionals are often called upon to work collaboratively with many other disciplines, including social work, education, law enforcement, and the courts, to ensure a multi-disciplinary approach to the recognition and treatment of child abuse.

A healthcare practitioner may, if medically indicated, take or cause to be taken a radiologic examination, physical examination, or other medical test of the child or take photographs that would provide medical indications for the child abuse assessment.

A physician has the authority to keep a child in custody without a court order and without the consent of a parent, guardian, or custodian, provided that the child is in a circumstance or condition that presents an imminent danger to the child’s life or health. However, the physician must orally notify the court within 24 hours. The ability to take or keep a child in custody is unique to physicians and peace officers.

Educators

Educators may spend more hours per day with children than their families. That’s why the role of educators is vital in the mandatory reporting process. All licensed school employees, teachers, coaches, and para-educators are mandatory reporters.

The involvement of educators in the reporting of child abuse is mandated or supported by federal standards and regulations and by state laws, policies, and procedures. Each of these government levels provides authority for, encourages, or mandates educator involvement in the reporting process by stating what is required of the educator and how that obligation is to be fulfilled.

The primary authority at the federal level is the Federal Family Education Rights and Privacy Act (FERPA) of 1974. This act, which governs the release of information from school records, does not bar the reporting of suspected child abuse by educators.

In the majority of cases, educators will be relying, not on school records, but on their own personal knowledge and observations when reporting child abuse. Because no school records are involved in these cases, FERPA does not apply.

In a small number of cases, it may be necessary to consult school records to determine whether a report of child abuse should be made. Ordinarily, parental consent is required before information contained in school records can be released. However, there are exceptions that can apply in cases of child abuse.

Some local school systems and boards of education have enacted school policies and procedures regarding child abuse reporting. The policies and procedures support state law with regard to reporting and often provide internal mechanisms to be followed when a report of child abuse is made. Local school policy may specify that parents be notified when the school makes a report of child abuse. If so, notify DHS of that local policy when making the report of child abuse. Sometimes local procedure may require that administrative staff be notified when a report of child abuse is made and a copy of the written report be filed.

Childcare Workers

Childcare providers play a critical role in keeping children safe. It is very important for them to report when they suspect child abuse. Childcare providers include childcare staff, foster parents, and residential care personnel. All of these people are mandatory reporters. A childcare provider who suspects that a child has been abused should report that to DHS and to the licensing worker.

Mental Health Professionals

Mental health professionals are often trusted with intimate information about children and families. This makes their role critical when reporting child abuse. All counseling providers, even those who are self-employed, are mandatory reporters of child abuse in regard to the child they counsel.

Law Enforcement Officers

Law enforcement officers play a very important role in protecting our children from child abuse. Law enforcement officers are seen as a symbol of public safety. They are in an excellent position to raise community awareness about child abuse.

Law enforcement officers often encounter situations that involve child abuse. For example, on domestic calls or during drug arrests the officer may learn of information that constitutes an allegation of child abuse. Children residing in homes where methamphetamine is being manufactured or where precursors are present constitutes an allegation of child abuse as well as possible criminal charges. Law enforcement is mandated to report to DHS.

Law enforcement officers who suspect child abuse in the line of duty are required to report that abuse to the Department of Human Services as soon as they suspect it. Law enforcement officers need to follow the same procedures as all mandatory reporters in reporting child abuse. Law enforcement and child protective services may need to work together. Sometimes child protective service workers must visit isolated, dangerous locations and deal with unstable, violent, or substance abusing individuals.

Child protective service workers sometimes do not have on-site communications (although today most have cell phones), weapons, or special training in self-protection. It is often necessary for law enforcement personnel to accompany child protective workers to conduct their assessment. Failure to have proper backup may have unfortunate consequences to both the child protection worker and the child who may have been abused.

Law enforcement has the power to arrest and to enforce any standing orders of the court. When it is necessary to remove a child from the child’s home, law enforcement officers are often called upon for assistance. Law enforcement has the general authority to take custody of children.

Law enforcement is often able to react to emergency situations faster than child protective services. Law enforcement is also available 24 hours a day, while the child protection workers’ after-hour response is limited in some communities.

Others Required to Report

Some employers may have specific policies that require certain training and reporting procedures regarding child abuse for their staff, even when they are not by law considered mandatory reporters.

 

Did You Know. . .

Reporters who by law are not considered mandatory reporters will be considered permissive reporters regardless of the employer’s requirements.

 

Iowa Administrative Code 441-175.23(2) mandates certified adoption investigators and DHS income maintenance workers to report suspected abuse. Income maintenance workers and certified adoption investigators are “mandated,” not mandatory reporters. As such, they are not required to make a written report, although they may do so if they wish. They receive the same information and notices as permissive reporters. They are not entitled to written notification that the assessment has been completed nor to a copy of information placed on the Registry. However, they may receive a copy of the report if they have another role with the child that allows access to the summary.

Required Training for Mandatory Reporters

Mandatory reporters are required by law to complete 2 hours of training during their first six months of employment and 2 hours every five years thereafter (IC 232.69).

The Iowa Administrative Rules, Chapter 93, designates the Iowa Department of Public Health to review and approve mandatory reporter training curricula for those persons who work in a position classification that under law makes the persons mandatory reporters of child or dependent adult abuse and the position classification does not have a mandatory reporter training curriculum approved by a licensing or examining board. In 2014 the code language in place since 2001 that mandated an abuse education review panel was revised (IDPH, 2017).

How Do I Report Child Abuse in Iowa?

Call 800 362 2178. According to Iowa Code section 232.70, if you are a mandatory reporter of child abuse and you suspect a child has been abused, you need to report it to the Department of Human Services. The law requires you to report suspected child abuse to DHS orally within 24 hours of becoming aware of the situation. You must also make a report in writing within 48 hours after your oral report.

The employer or supervisor of a person who is a mandatory or permissive reporter shall not apply a policy, work rule, or other requirement that interferes with the person making a report of child abuse. As a mandatory reporter, you are also required to make an oral report to law enforcement if you have reason to believe that immediate protection of the child is necessary.

The law requires the reporting of suspected child abuse. It is not the reporter’s role to validate the abuse. The law does not require you to have proof that the abuse occurred before reporting. The law clearly specifies that reports of child abuse must be made when the person reporting “reasonably believes a child has suffered abuse.”

 

Did You Know. . .

Reports are made in terms of the child’s possible condition, not in terms of an accusation against parents.

 

A report of child abuse is not an accusation, but a request to determine whether child abuse exists and begin the helping process.

Making a report of child abuse may be difficult. You may have doubts about whether the circumstances merit a report, how the parents will react, what the outcome will be, and whether the report will put the child at greater risk. The best way to minimize the difficulty of reporting is to:

  • Be knowledgeable about the reporting requirements, and
  • Be aware of the department’s intake criteria and the response that is initiated by making a report.

Within 24 hours of receiving your report, DHS will notify you orally as to whether the report has been accepted or rejected. Within five working days, you will also be sent form 470-3789, Notice of Intake Decision, indicating whether the report of child abuse was accepted or rejected.

Reporting Procedures

If you see a child in imminent danger, immediately contact law enforcement (911) to provide immediate assistance to the child. Law enforcement is the only profession that can take a child into custody in that situation. After you have notified law enforcement, then call DHS. To report a suspected case of child abuse:

  • Call 800 362 2178.
  • Then, follow up by making a written report within 24 hours.

Oral and written reports should contain the following information, if it is known:

  • The names and home address of the child and the child’s parents or other persons believed to be responsible for the child’s care.
  • The child’s present whereabouts.
  • The child’s age.
  • The nature and extent of the child’s injuries, including any evidence of previous injuries.
  • The name, age, and condition of other children in the same household.
  • Any other information that you believe may be helpful in establishing the cause of the abuse or neglect to the child.
  • The identity of the person or persons responsible for the abuse or neglect to the child.
  • Your name and address.

Form 470-0665, Report of Suspected Child Abuse, can be found in the DHS Guide for Mandatory Reporters, available online through the DHS website.

If you suspect sexual abuse of a child under the age of 12 by a non-caretaker, you are required by law to make a report of child abuse to DHS. If the child is age 12 or older, you may report the sexual abuse by a non-caretaker but you are not required by law to do so. DHS must report all sexual abuse allegations to law enforcement within 72 hours.

Waiver of Confidentiality

The issues of confidentiality and privileged communication are often areas of concern for mental health and health service professionals.

 

Did You Know. . .

Rules around confidentiality and privileged communication are waived during the child abuse assessment process once a report of child abuse becomes a case.

 

Iowa Code section 232.71B indicates that the Department may request information from any person believed to have knowledge of a child abuse case. County attorneys, law enforcement officers, social services agencies, and all mandatory reporters (whether or not they made the report of suspected abuse) are obligated to cooperate and assist with the child abuse assessment upon the request of the Department.

Confidentiality is waived in Iowa Code section 232.74, which reads:

Sections 622.9 and 622.10 and any other statute or rule of evidence which excludes or makes privileged the testimony of a husband or wife against the other or the testimony of a health practitioner or mental health professional as to confidential communications, do not apply to evidence regarding a child’s injuries or the cause of the injuries in any judicial proceeding, civil or criminal, resulting from a report pursuant to this chapter or relating to the subject matter of such a report.

Physician privilege is waived in cases of suspected child abuse. Physicians are allowed to share whatever information is necessary with the Department of Human Services to facilitate a thorough assessment.

It is wise to let your clients know your status as a child abuse reporter at the onset of treatment. This will help establish an open relationship and minimize the client’s feelings of betrayal if a report needs to be made. Making a child abuse referral does not necessarily mean that your relationship with the child and family will end, especially when you are able to support the family during the assessment process.

When possible, discuss the need to make a child abuse report with the family. However, be aware that there are certain situations where, if the family is warned about the assessment process, the child may be at risk for further abuse or the family may leave with the child.

In situations where you are not required to make a child abuse report, ethically you need to address these concerns in a therapeutic setting. Refer to your Professional Code of Ethics for further clarification on issues surrounding child abuse.

Immunity from Liability

Iowa Code section 232.73 provides immunity from any civil or criminal liability that might otherwise be incurred or imposed when a person participates in good faith in:

  • Making a report, photographs, or x-rays,
  • Performing a medically relevant test, or
  • Assisting in an assessment of a child abuse report.

A person has the same immunity with respect to participation in good faith in any judicial proceeding resulting from the report or relating to the subject matter of the report.

In this section and section 232.77, medically relevant test means a test that produces reliable results of exposure to cocaine, heroin, amphetamine, methamphetamine, or other illegal drugs, or their combinations or derivatives, including a drug urine screen test.

Sanctions for Failure to Report Child Abuse

Iowa Code section 232.75 provides for civil and criminal sanctions for failing to report child abuse. Any person, official, agency, or institution required by this chapter to report a suspected case of child abuse who knowingly and willfully fails to do so is guilty of a simple misdemeanor.

Any person, official, agency, or institution required by Iowa Code section 232.69 to report a suspected case of child abuse who knowingly fails to do so, or who knowingly interferes with the making of such a report in violation of section 232.70, is civilly liable for the damages proximately caused by such failure or interference.

Sanctions for Reporting False Information

The act of reporting false information regarding an alleged act of child abuse to DHS or causing false information to be reported, knowing that the information is false or that the act did not occur, is classified as a simple misdemeanor under Iowa Code section 232.75, subsection 3.

If DHS receives a fourth report that identifies the same child as a victim of child abuse and the same person as the alleged abuser or that is from the same person, and DHS determined that the three earlier reports were entirely false or without merit, DHS may:

  • Determine that the report is again false or without merit due to the report’s spurious or frivolous nature
  • Terminate its assessment of the report
  • Provide information concerning the reports to the county attorney for consideration of criminal charges

Indicators of Possible Child Abuse

The following physical and behavioral indicators are listed as signs of possible child abuse for you to consider in making your report. These indicators need to be evaluated in the context of the child’s environment. The presence of one or more of these symptoms does not necessarily prove abuse. These lists are examples and are not all-inclusive.

Physical indicators

  • Bruises and welts on the face, lips, mouth, torso, back, buttocks, or thighs in various stages of healing
  • Bruises and welts in unusual patterns reflecting the shape of the article used (eg, electric cord, belt buckle) or in clusters indicating repeated contact
  • Bruises on infant, especially facial bruises
  • Subdural hematomas, retinal hemorrhages, internal injuries
  • Cigarette burns, especially on the soles, palms, back, or buttocks
  • Immersion burns (sock-like, glove-like, doughnut-shaped) on buttocks or genitalia
  • Burns patterned like an electric element, iron, or utensil
  • Rope burns on arms, legs, neck, or torso
  • Fractures of the skull, nose, ribs, or facial structure in various stages of healing
  • Multiple or spiral fractures
  • Unexplained (or multiple history for) bruises, burns, or fractures
  • Lacerations or abrasions to the mouth, frenulum, lips, gums, eyes, or external genitalia
  • Bite marks or loss of hair
  • Speech disorders, lags in physical development, ulcers
  • Asthma, severe allergies, or failure to thrive
  • Consistent hunger, poor hygiene, inappropriate dress
  • Consistent lack of supervision, abandonment
  • Unattended physical or emotional problems or medical needs
  • Difficulty in walking or sitting
  • Pain or itching in the genital area
  • Bruises, bleeding or infection in the external genitalia, vaginal, or anal areas
  • Torn, stained, or bloody underclothing
  • Frequent urinary or yeast infections
  • Venereal disease, especially in pre-teens
  • Pregnancy
  • Substance abuse—alcohol or drugs
  • Positive test for presence of illegal drugs in the child’s body

Behavior indicators

  • Afraid to go home; frightened of parents
  • Alcohol or drug abuse
  • Apprehensive when children cry, overly concerned for siblings
  • Begging, stealing, or hoarding food
  • Behavioral extremes, such as aggressiveness or withdrawal
  • Complaints of soreness, uncomfortable movement
  • Constant fatigue, listlessness, or falling asleep in class
  • Delay in securing or failure to secure medical care
  • Delinquent, runaway, or truant behaviors
  • Destructive, antisocial, or neurotic traits, habit disorders
  • Developmental or language delays
  • Excessive seductiveness or promiscuity
  • Extended stays at school (early arrival and late departure)
  • Extreme aggression, rage, or hyperactivity
  • Fear of a person or an intense dislike of being left with someone
  • Frequently absent or tardy from school or drops out of school or sudden school difficulties
  • History of abuse or neglect provided by the child
  • Inappropriate clothing for the weather
  • Massive weight change
  • Indirect allusions to problems at home such as “I want to live with you”
  • Lack of emotional control, withdrawal, chronic depression, hysteria, fantasy, or infantile behavior
  • Lags in growth or development
  • Multiple or inconsistent histories for a given injury
  • Overly compliant, passive, undemanding behavior; apathy
  • Poor peer relationships; shunned by peers
  • Poor self-esteem, self-devaluation, lack of confidence, or self-destructive behavior
  • Role-reversal behavior or overly dependent behavior; states there is no caretaker
  • Suicide attempts
  • Unusual interest in or knowledge of sexual matters, expressing affection in inappropriate ways
  • Wary of adult contacts, lack of trust, uncomfortable with or threatened by physical contact or closeness

What Is Child Abuse Under Iowa Law?

The Department of Human Services has the legal authority to conduct an assessment of child abuse when it is alleged that:

  • The victim is a child.
  • The child is subjected to one or more of the ten categories of child abuse defined in Iowa Code section 232.68:
    • Physical abuse
    • Mental injury
    • Sexual abuse
    • Denial of critical care
    • Child prostitution
    • Sexual trafficking
    • Presence of illegal drugs
    • Manufacturing or possession of a dangerous substance
    • Bestiality in the presence of a minor
    • Allows access by a registered sex offender
    • Allows access to obscene material
    • Recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a child for the purpose of commercial sexual activity
  • The abuse is the result of the acts or omissions of the person responsible for the care of the child.

Child

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.

Caretaker

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:

  • Parent, guardian, or foster parent
  • A relative or any other person with whom the child resides and who assumes care or supervision of the child, without reference to the length of time or continuity of such residence
  • An employee or agent of any public or private facility providing care for a child, including an institution, hospital, health care facility, group home, mental health center, residential treatment center, shelter care facility, detention center, or child care facility
  • Any person providing care for a child, but with whom the child does not reside, without reference to the duration of the care

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.

Educators as Caretakers

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 as Caretakers

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

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:

  • Extreme aggression
  • Withdrawal
  • Seductive behaviors
  • Being uncomfortable with physical contact or closeness

Mental Injury

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:

  • Ignoring the child and failing to provide necessary stimulation, responsiveness, and validation of the child’s worth in normal family routine
  • Rejecting the child’s value, needs, and request for adult validation and nurturance
  • Isolating the child from the family and community; denying the child normal human contact
  • Terrorizing the child with continual verbal assaults, creating a climate of fear, hostility, and anxiety, thus preventing the child from gaining feelings of safety and security
  • Corrupting the child by encouraging and reinforcing destructive, antisocial behavior until the child is so impaired in socio-emotional development that interaction in normal social environments is not possible
  • Verbally assaulting the child with constant, excessive name-calling, harsh threats, and sarcastic put downs that continually “beat down” the child’s self-esteem with humiliation
  • Over-pressuring the child with subtle but consistent pressure to grow up fast and to achieve too early in the areas of academics, physical or motor skills, or social interaction, which leaves the child feeling that he or she is never quite good enough

Sexual Abuse

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:

  • First-degree sexual abuse
  • Second-degree sexual abuse
  • Third-degree sexual abuse
  • Lascivious acts with a child
  • Indecent exposure
  • Assault with intent to commit sexual abuse
  • Indecent contact with a child
  • Lascivious conduct with a minor
  • Incest
  • Sexual exploitation by a counselor, therapist, or school employee
  • Sexual exploitation of a minor
  • Sexual misconduct with offenders and juveniles
  • Invasion of privacy (nudity)

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.

Sexual Trafficking

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:

  • Has an explicitly sexual online profile.
  • Depicts sexual exploitation in drawing, poetry, or other modes of creative expression
  • Presents with frequent or multiple sexually transmitted diseases or pregnancies.
  • Lies about or unaware of his or her true age.
  • Has no knowledge of personal data, such as date of birth.
  • Wears sexually provocative clothing, has new clothes, gets hair and nails done with no financial means.
  • Expresses secrecy about whereabouts.
  • Is in a controlling or dominating relationship.
  • Exhibits hyper-vigilance or paranoid behaviors.
  • Expresses interest in or is in relationships with adults or much older men or women.

Denial of Critical Care

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:

  1. Failure to provide adequate food and nutrition to such an extent that there is danger of the child suffering injury or death
  2. Failure to provide adequate shelter to such an extent that there is danger of the child suffering injury or death
  3. Failure to provide adequate clothing to such an extent that there is danger of the child suffering injury or death
  4. Failure to provide adequate health care to such an extent that there is danger of the child suffering serious injury or death
  5. Failure to provide the mental health care necessary to adequately treat an observable and substantial impairment in the child’s ability to function
  6. Gross failure to meet the emotional needs of the child necessary for normal development evidenced by the presence of an observable and substantial impairment in the child’s ability to function within the normal range of performance and behavior
  7. Failure to provide proper supervision of a child which a reasonable and prudent person would exercise under similar facts and circumstances, to such an extent that the failure resulted in direct harm or created a risk of harm to the child or there is danger of the child suffering injury or death.

     

    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:

     

    • Illegal drug usage by the caretaker of a child. When you make an allegation of denial of critical care because a child lacks proper supervision due to illegal drug usage by a caretaker you may be asked questions to help DHS determine the type of drug and the degree of risk to the child. Some illegal drugs may have a greater impact on the supervision abilities of the caretaker than others. For example, methamphetamine usage by a child’s caretaker has inherent risks to the child given the known effects of methamphetamines. DHS will consider the known effect of the drug named and other information to assess risk to the child’s safety. You may be asked about the child’s access to the drugs and about the caretaker’s use of drugs, being under the influence of drugs while supervising or transporting child, dealing drugs, possession of weapons, etc.
    • Children home alone. DHS receives many inquiries each year regarding when a child can be left home alone safely. Iowa law does not define an age that is appropriate for a child to be left alone. Each situation is unique. Examples of questions to help determine whether there are safety concerns for the child include:

       

      • Does the child have any physical disabilities?
      • Could the child get out of the house in an emergency?
      • Does the child have a phone and know how to use it?
      • Does the child know how to reach the caretaker?
      • How long will the child be left home alone?
      • Is the child afraid to be left home alone?
      • Does the child know how to respond to an emergency such as fire or injury?
    • Lice and truancy. Head lice and truancy are often reported as child abuse allegations. However, the endangerment does not generally rise to the level that must be present to constitute a child abuse allegation. If other conditions are present or the situation poses a risk to the child’s health and welfare, it should be reported as child abuse. Even if the report is rejected for assessment, other services may be offered to the child and family.
  8. Failure to respond to the infant’s life-threatening conditions by failing to provide treatment which in the treating physician’s judgment will be most likely to be effective in ameliorating or correcting all conditions. This subcategory or the denial of critical care abuse type is also known as “withholding of medically indicated treatment.” The type of treatments included are appropriate nutrition, hydration, and medication. The term does not include the failure to provide treatment other than appropriate nutrition, hydration, and medication to an infant when, in the treating physician’s medical judgment, any of the following circumstances apply:

     

    • The infant is chronically and irreversibly comatose. The provision of treatment would merely prolong dying, not be effective in ameliorating or correcting all of the infant’s life-threatening conditions, or otherwise be futile in terms of the survival of the infant. The provision of the treatment would be virtually futile in terms of the survival of the infant and the treatment itself under the circumstances would be inhumane.

Child Prostitution

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

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.

The Comprehensive Addiction and Recovery Act of 2016 (CARA)

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:

  • An infant is born with illegal drugs present in the infant’s system as determined by a medical test. The illegal drugs were present in the infant’s body due to the illegal drug usage by the mother before the baby’s birth.
  • A 3-year-old child tests positive for illegal drugs due to exposure to the illegal drugs when the child’s caretakers used illegal drugs in the child’s home.

Dangerous Substances

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:

  • In the physical presence of a child, or
  • In a child’s home, on the premises, or in a motor vehicle located on the premises, or
  • Under other circumstances in which a reasonably prudent person would know that the manufacture or possession may be seen, smelled, or heard by a child.

Iowa Code section 232.2, subsection 6, paragraph p, defines dangerous substance as:

  • Amphetamine, its salts, isomers, or salts of its isomers
  • Methamphetamine, its salts, isomers, or salts of its isomers
  • A chemical or combination of chemicals that poses a reasonable risk of causing an explosion, fire, or other danger to the life or health of people who are in the vicinity while the chemical or combination of chemicals is used or is intended to be used in any of the following:
    • The process of manufacturing an illegal or controlled substance
    • As a precursor in the manufacturing of an illegal or controlled substance
    • As an intermediary in the manufacturing of an illegal or controlled substance

Note: DHS must report this type of allegation to law enforcement, as this is a criminal act.

Bestiality in the Presence of a Minor

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.

Allows Access by a Registered Sex Offender

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.

Allows Access to Obscene Material

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.

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.

How Is Child Abuse Information Treated in Iowa?

Iowa Code section 235A.15 provides that confidentiality of child abuse information shall be maintained, except as specifically authorized. Under Iowa law, child abuse information includes any or all of the following data maintained by DHS in a manual or automated data storage system and individually identified:

  • Report data, including information pertaining to an assessment of an allegation of child abuse in which DHS has determined the alleged abuse meets the definition of child abuse
  • Assessment data, including information pertaining to the DHS evaluation of a family.
  • Disposition data, including information pertaining to an opinion or decision as the occurrence of child abuse

Note: Iowa Code section 232.71B, subsection 2, directs that DHS shall not reveal the identity of the reporter of child abuse in the written notification to parents or otherwise. The department shall withhold the name of the person who made the report of suspected child abuse. Only the court may allow the release of that person’s name.

Protective Disclosure

Iowa Code (232.71B, subsection 9) allows for DHS to disclose that an individual is listed on the child abuse registry, the dependent adult abuse registry, or is required to register for the sexual offender registry when it is necessary for the protection of a child. The disclosure can only be made to persons who are subjects of a child abuse assessment.

Disposition of Reports

Iowa law (IC 235A.15) limits access to child abuse information to specific individuals and entities depending on placement of the Child Abuse Registry. All subjects of the report and their attorneys have access to:

  • Information contained within the Child Protective Services Assessment Summary
  • Correspondence or written information that pertains to Child Protective Services Assessment Summary.

A copy of the entire Child Protective Services Assessment Summary is automatically provided to subjects, including but not limited to the custodial and noncustodial parents.

If a person with access to the Child Protective Services Assessment Summary as a result of the current assessment does not have access to all information listed from previous summaries, the inaccessible information is deleted before providing the summary to that person.

Note: The safety assessment, safety plan, and family risk assessment are considered assessment data, and their dissemination by law is more restrictive.

A person who is the subject of a child abuse report may also receive a copy of the Child Protective Services Assessment Summary for that report by submitting a request to the Department. Subjects may use either the Request for Child Abuse Information or the Notice of Child Abuse Assessment to make this request.

Mandatory reporters may request a founded report using either form. They will receive a Notice of Child Abuse Assessment when the assessment report is completed as the reporter of the abuse. Mandatory reporters may also request founded reports when they are providing care or treatment to a child victim, their families or the person responsible for the abuse.

All other requesters must use the Request for Child Abuse Information to request a copy of the assessment report.

Requests for Correction and Appeals

A subject (child, parent, guardian or legal custodian, alleged perpetrator) who feels there is incorrect or erroneous information contained in the Child Protective Services Assessment Summary, or who disagrees with its conclusions, may request a correction of the report.

The subject must submit a written request within 90 days from the date on the Notice of Child Abuse Assessment. The appeal can be a letter of explanation or completion of an Appeal and Request for Hearing Form. The form can be completed online at: https://dhs.iowa.gov/appeals/appeal-a-dhs-decision, or mailed to:

Department of Human Services
Appeals Section
1305 E Walnut St, 5th Floor
Des Moines, Iowa 50319-0114

An administrative hearing and or a prehearing is then scheduled. At the evidentiary hearing, the matter will be heard before an administrative law judge. The administrative law judge may also uphold, modify, or overturn the finding.

A requester who is not satisfied with the decision of the administrative law judge may appeal the matter to the district court.

Access to Child Abuse Information

Another function of the Child Abuse Registry is approval of the dissemination of child abuse information to persons authorized to receive this information. Iowa Code section 235A.17 indicates that an authorized recipient of child abuse information shall not re-disseminate the information to anyone else.

Access to child abuse information is authorized for:

  • Subjects of a report (child, parent, guardian or legal custodian, alleged perpetrator)
  • The attorney for any subject
  • An employee or agent of DHS who is responsible for assessment of the report of child abuse
  • Other DHS personnel when necessary for the performance of their official duties and functions
  • The mandatory reporter who reported the abuse
  • The county attorney
  • The juvenile court

Access to child abuse information is also authorized to persons involved in an assessment of child abuse (such as a health practitioner or mental health professional, a law enforcement officer, or a multidisciplinary team).

Access to certain child abuse information is authorized to individuals, agencies, or facilities providing care to a child named in a report that includes:

  • A facility licensing authority
  • A person or agency responsible for the care of a child victim or perpetrator
  • An administrator of a psychiatric medical institution
  • An administrator of a child foster care facility
  • An administrator of a registered or licensed childcare facility
  • The superintendent of the Iowa Braille and Sightsaving School
  • The superintendent of the School for the Deaf
  • An administrator of a community mental health center
  • An administrator of an agency providing services under a county management plan
  • An administrator of a facility or program operated by the state, city or county providing direct care to children for applicant and employee record checks
  • An administrator of an agency providing Medicaid home- and community-based waiver services for applicant and employee record checks
  • An administrator of a childcare resource and referral agency under contract with DHS
  • An administrator of a hospital for applicant and employee record checks

Access to child abuse information is also authorized under some circumstances related to judicial and administrative proceedings, such as:

  • The juvenile court
  • A juvenile court officer
  • A Court appointed special advocate
  • An expert witness at any stage of an appeal hearing
  • A district court
  • A probation or parole officer
  • An adult correctional officer
  • Each board of examiners and licensing board
  • A court or agency hearing an appeal for correction of child abuse information
  • The Department of Justice for review by the prosecutor’s review committee or the commitment of sexually violent predators

Access to certain child abuse information is also authorized to others under certain circumstances, including:

  • A person conducting bona fide child abuse research
  • DHS personnel for official duties
  • A DHS employee for record checks of state operated institutions employees
  • A DHS registration or licensing employee
  • A DHS adoption worker
  • The attorney for DHS
  • A certified adoption investigator
  • A certified adoption worker
  • A child protection agency from another state for investigative, treatment or adoptive or foster care placement services
  • Foster care review boards, or to conduct a record check evaluation
  • The Board of Educational Examiners
  • A legally authorized protection and advocacy agency
  • The Iowa Board for the Treatment of Sexual Offenders
  • A licensed child placing agency for adoptive placement
  • The superintendent or designee of school district, or authorities for a nonpublic school, for employee and volunteer record checks
  • Department of Inspections and Appeals for applicants for employment

Civil and Criminal Liability

According to Iowa Code section 235A.20:

Any aggrieved person may institute a civil action for damages under chapter 669 or 670 or to restrain the dissemination of child abuse information in violation of this chapter, and any person, agency or other recipient proven to have disseminated or to have requested and received child abuse information in violation of this chapter, or any employee of the department who knowingly destroys assessment data except in accordance with rule as established by the department for retention of child abuse information under section 235A.18 shall be liable for actual damages and exemplary damages for each violation and shall be liable for court costs, expenses, and reasonable attorney’s fees incurred by the party bringing the action.

Also, according to Iowa Code section 235A.21, the following people are guilty of a serious misdemeanor under the Iowa criminal code:

  • Any person who willfully requests, obtains, or seeks to obtain child abuse information under false pretenses
  • Any person who willfully communicates or seeks to communicate child abuse information to any agency or person except in accordance with Iowa Code sections 235A.15 and 235A.17
  • Any person connected with any research authorized pursuant to Iowa Code section 235A.15 who willfully falsifies child abuse information or any records relating to child abuse information
  • Any person who knowingly, but without criminal purpose, communicates, or seeks to communicate child abuse information except in accordance with sections 235A.15 and 235A.17 shall be guilty of a simple misdemeanor.

Risk Factors and Prevention of Child Abuse

A combination of individual, relational, community, and societal factors contribute to the risk of child abuse and neglect. Although children are not responsible for the harm inflicted upon them, certain characteristics have been found to increase their risk of being maltreated. Risk factors are those characteristics associated with child abuse and neglect—they may or may not be direct causes (CDC, 2016).

Risk Factors for Victimization

Individual risk factors

  • Children younger than 4 years of age
  • Special needs that may increase caregiver burden (eg, disabilities, mental retardation, mental health issues, and chronic physical illnesses) (CDC, 2016).

Risk Factors for Perpetration

Individual Risk Factors

  • Parents’ lack of understanding of children’s needs, child development and parenting skills
  • Parents’ history of child maltreatment in family of origin
  • Substance abuse and/or mental health issues including depression in the family
  • Parental characteristics such as young age, low education, single parenthood, large number of dependent children, and low income
  • Non-biological, transient caregivers in the home (eg, mother’s male partner)
  • Parental thoughts and emotions that tend to support or justify maltreatment behaviors (CDC, 2016).

Family risk factors

  • Social isolation
  • Family disorganization, dissolution, and violence, including intimate partner violence
  • Parenting stress, poor parent-child relationships, and negative interactions (CDC, 2016).

Community risk factors

  • Community violence
  • Concentrated neighborhood disadvantage (e.g., high poverty and residential instability, high unemployment rates, and high density of alcohol outlets), and poor social connections (CDC, 2016).

Protective Factors for Child Maltreatment

Protective factors buffer children from being abused or neglected. These factors exist at various levels. Protective factors have not been studied as extensively or rigorously as risk factors. However, identifying and understanding protective factors are equally as important as researching risk factors (CDC, 2016).

There is scientific evidence to support the following protective factor:

Family protective factors

  • Supportive family environment and social networks (CDC, 2016).

Several other potential protective factors have been identified. Research is ongoing to determine whether the following factors do indeed buffer children from maltreatment (CDC, 2016).

Family Protective Factors

  • Nurturing parenting skills
  • Stable family relationships
  • Household rules and child monitoring
  • Parental employment
  • Adequate housing
  • Access to health care and social services
  • Caring adults outside the family who can serve as role models or mentors (CDC, 2016).

Community protective factors

  • Communities that support parents and take responsibility for preventing abuse (CDC, 2016).

Strategies for Prevention of Child Abuse

Child abuse and neglect are serious problems that can have lasting harmful effects on victims. The goal for child maltreatment prevention is clear—to stop child abuse and neglect from happening in the first place. Child abuse is a complex problem rooted in unhealthy relationships and environments. Safe, stable, nurturing relationships and environments for all children and families can prevent child abuse. However, the solutions are as complex as the problem (CDC, 2016a).

Child abuse and neglect are complex problems rooted in unhealthy relationships and environments. Preventing child abuse and neglect requires a comprehensive approach that influences all levels of the social ecology (including the societal culture), community involvement, relationships among families and neighbors, and individual behaviors. Effective prevention strategies focus on modifying policies, practices, and societal norms to create safe, stable, nurturing relationships and environments. (CDC, 2016a).

The Centers for Disease Control and Prevention offers extensive information and links on child abuse prevention techniques and programs at its website. A number of studies and programs are particularly relevant to health care providers who may be involved with child abuse situations.

The Iowa Child Abuse Prevention Program (ICAPP) is a state and federally funded program that was established by Iowa Legislature in 1982. Prevent Child Abuse Iowa administers the program, as well as providing assistance and guidance to the organizations that offer direct family support with ICAPP funds. Their website is: http://www.pcaiowa.org/.

Safe Haven for Newborns

What Is the Newborn Safe Haven Act?

Iowa has joined thirty other states in creating safe havens for infants. The Newborn Safe Haven Act (Iowa Code Chapter 233) is a law that allows parents (or another person who has the parent’s authorization) to leave an infant up to 14 days old at a hospital or healthcare facility without fear of prosecution for abandonment (DHS, 2017).

What Is a Safe Haven?

A safe haven is an institutional health facility, which is defined according to the Act to be:

  • A “hospital” as defined in Iowa Code section 135B.1, including a facility providing medical or health services that is open 24 hours per day, 7 days per week, and is a hospital emergency room; or
  • A “healthcare facility” as defined in Iowa Code section 135C.1, including a residential care facility, a nursing facility, an intermediate care facility for persons with mental illness, or an intermediate care facility for persons with mental retardation.

The health facility may ask for but cannot require names of the parents and medical history of baby and parents. The facility must notify DHS as soon as possible by calling 800 362 2178 that physical custody of an infant has been taken under the Safe Haven Act. DHS will make the necessary court and legal contacts and assume care, control, and custody of the child.

The Act provides immunity from prosecution for abandonment for a parent (or a person acting with the parent’s authorization) who leaves an infant at a hospital or healthcare facility.

The Act provides immunity from civil or criminal liability for hospitals, healthcare facilities, and persons employed by those facilities that perform reasonable acts necessary to protect the physical health and safety of the infant (DHS, 2017).

More information for parents and facilities is available from the DHS website.

Resources and References

Iowa Resources

Abuse Reporting for Children and Dependent Adult Abuse
Including reports of suspected child sex trafficking. The names of reporters of abuse are never made public.
800 362 2178 (24 hrs)

Child Abuse Council
The Child Abuse Council is a regional, non-profit agency with more than 39 years experience providing child abuse prevention, education, and treatment programs for children and families in the bi-state metropolitan area and surrounding communities. Our goals for every child served are (1) a safe and nurturing home; (2) a secure parent-child relationship; and (3) an environment supporting successful growth and development. Serving the Quad City region.
http://www.childabuseqc.org/
info@childabuseqc.org
524 15th Street
Moline, IL 61265
309 736 7170
OR
Mississippi Valley Child Protection Center
1600 Mulberry Avenue
Muscatine IA 52761
563 264 0580

Child Abuse Prevention Council of Warren County
In partnership with communities in Warren County, the council provides support, instruction, and services to families to prevent child abuse. It operates the Wee Care Respite Nursery, the Young Parents information and support program and a Sexual Abuse Prevention Program in Warren County, Iowa. The council also coordinates community awareness about child abuse and the importance of prevention. In 2009 the council began working with Warren County Public Health, Child Care Resource and Referral and Simpson College to create the Shaken Baby Prevention Partnership. As a result of this collaboration, the partnership now offers educational presentations designed to increase awareness, and to prevent Shaken Baby Syndrome by teaching participants how to cope with a crying baby.
515 971 2977
info@cap.warren.ia.us
http://www.cap.warren.ia.us/

Child Abuse Prevention Services
Child Abuse Prevention Services, located in Marshalltown, Iowa, is organized to prevent child abuse in Marshall County and the surrounding area. It was established as a grassroots effort working to address the problem of child abuse in Marshall County and the surrounding areas. Believing that prevention was the answer, the private non-profit organization was established in 1981.
641 752 1730
Fax 641 753 1336
http://www.capsonline.us

Child Welfare Partners Committee
Established in 2008 to provide overall guidance and leadership by focusing on the full range of child welfare contracted services. Sets the tone for the collaborative public-private work groups and ensures coordination of messages, activities, and products. Includes both contractor (private) and DHS (public) representatives.
http://dhs.iowa.gov/about/advisory-groups/childwelfare/partner-committee

Children and Families of Iowa
Operates the Iowa Domestic Violence Hotline: a toll-free service for victims, loved ones, and community members. Certified Domestic Violence Advocates are available 24 hours a day to provide crisis support, help victims find safe solutions across the state, answer questions, and provide resource referrals.
Iowa domestic violence hotline: 800 942 0333
http://cfiowa.org/programs/domestic-violence/iowa-domestic-violence-hotline/

HAWK-I (Healthy and Well Kids in Iowa)
Provides health and dental coverage for children in eligible families
https://dhs.iowa.gov/hawk-i
hawk-i@dhs.state.ia.us
800 257 8563
515 457 7701 (fax)
Relay Iowa TTY 800 735 2942

Iowa Department of Human Services
800 972 2017
800 735 2942 (TTY)
http://dhs.iowa.gov/
http://dhs.iowa.gov/dhs_office_locator

Polk County Crisis and Advocacy Services
Polk County Crisis & Advocacy Services (PCCAS) is a division of the Polk County Department of Community, Family & Youth Services that provides assistance to victims of crime in Polk County regardless of race, gender, age, ethnicity, sexual orientation, physical or mental disabilities.
515 286 3600
http://www.polkcountyiowa.gov/cfys/services/crisis-advocacy-services/

Prevent Child Abuse Iowa
Prevent Child Abuse Iowa’s fundamental mission is to end child abuse in the entire state of Iowa. Its focus on prevention is unique in the child abuse field, where most efforts involve treating children and families after abuse has already occurred. It is the only statewide organization dedicated to preventing child abuse through advocacy, research, and communications. These platforms are not only used to raise awareness of the cause but also support the work of local organizations that operate in alliance with our mission.

Prevent Child Abuse Iowa also manages state and federal grant programs, which contribute financial support to community groups that provide services to families. These services offer education to parents and assist families in building positive support systems. Prevent Child Abuse Iowa provides ongoing training and education to its grantees in order to enhance their ability to prevent child abuse before it occurs.
515 244 2200
515 280 7835 (fax)
800 237 1815 (toll free)

Safe Haven for Newborns
The Safe Haven Act is a law that allows parents—or another person who has the parent’s authorization—to leave an infant up to 14 days old at a hospital or healthcare facility without fear of prosecution for abandonment.
http://dhs.iowa.gov/safe-haven

National Resources

Centers for Disease Control and Prevention
Child Maltreatment Prevention website
http://www.cdc.gov/violenceprevention/childmaltreatment/index.html

Annie E. Casey Foundation
The Annie E. Casey Foundation is a private charitable organization dedicated to helping build better futures for disadvantaged children in the United States. It uses its resources to partner with and forge collaborations among institutions, agencies, decision makers, and community leaders so they can work together to transform tough places to raise families. We fund research, technical assistance, and multi-site demonstrations that help service and support systems like public schools, juvenile justice agencies, and child welfare systems get better results for kids and families. We directly deliver exemplary services, identify and measure what works, and share lessons learned to demonstrate the potential of reforming public policies and services on behalf of children and their families.
410 547 6600
410 547 6624 (fax)
webmail form at: http://www.aecf.org/contact
http://www.aecf.org/

Center for Law and Social Policy
Develops and advocates for federal, state, and local policies to strengthen families and create pathways to education and work.
202 906 8000
http://www.clasp.org/

Child Welfare Information Gateway / U.S. Department of Health Human Services
Resources on child abuse prevention, protecting children from risk of abuse, and strengthening families. Includes information on supporting families, protective factors, public awareness, community activities, positive parenting, prevention programs, and more.
https://www.childwelfare.gov/topics/can/

Child Welfare League of America
A coalition of hundreds of private and public agencies serving vulnerable children and families since 1920. Provides expertise, leadership and innovation on policies, programs, and practices help improve the lives of millions of children in all fifty states.
202 688 4200
http://www.cwla.org/

National Human Trafficking Hotline
If you need help or see something suspicious. Specialists available 24/7 to take reports. All reports are confidential and you may remain anonymous. Interpreters are available.
888 373 7888 or text “Help” to BEFREE (233733)

References

Centers for Disease Control and Prevention (CDC). (2016). Child Maltreatment: Risk and Protective Factors. Retrieved May 30, 2014 from http://www.cdc.gov/violenceprevention/childmaltreatment/ riskprotectivefactors.html.

Centers for Disease Control and Prevention (CDC). (2016a). Child Maltreatment: Prevention Strategies. Retrieved May 30, 2014 from http://www.cdc.gov/violenceprevention/childmaltreatment/prevention.html.

Coreless M. (2016). New Iowa laws take effect today. Retrieved April 2, 2017 from http://www.kwwl.com/story/32353129/2016/07/Friday/new-iowa-laws-take-effect-today. Article links to http://iowahouse.org/pdf/6-22-16_NewLawsList.pdf.

Doyne S, Bowermaster J, Meloy R. (1999). Custody disputes involving domestic violence: Making children’s needs a priority. Juvenile & Family Court Journal 50(2), 1–12.

Edleson JL. (2011). Emerging Responses to Children Exposed to Domestic Violence. October 2006, updated July 2011. VAWnet, a project of the National Resource Center on Domestic Violence. Retrieved March 20, 2017 from http://vawnet.org/material/emerging-responses-children-exposed-domestic-violence.

Futures Without Violence (FWV). (2013). The Facts on Children’s Exposure to Intimate Partner Violence. Retrieved March 25, 2017 from https://www.futureswithoutviolence.org/userfiles/file/Fact%20sheet%20on%20Children%20Exposed%20to%20IPV%202013.pdf.

Iowa Department of Human Services (DHS). (2017). Safe Haven. Retrieved April 4, 2017 from http://dhs.iowa.gov/safe-haven.

Iowa Department of Human Services (DHS). (2015). Assessed Reports of Child Neglect and Abuse by Level of Finding for CY2015. Child Maltreatment Statistical Report. Child Abuse Statistics. Retrieved March 16, 2017 from http://www.dhs.iowa.gov/reports/child-abuse-statistics / http://dhs.iowa.gov/sites/default/files/Child_maltreatment_CY2015.xls.

Iowa Department of Human Services (DHS). (2015a). Differential Response System Overview 2015. Retrieved April 3, 2017 from https://dhs.iowa.gov/sites/default/files/DR_System_Overview_CY2015.pdf.

Iowa Department of Human Services (DHS). (2015b). Iowa Child Welfare by the Numbers–Calendar Year 2015. Retrieved March 25, 2017 from http://dhs.iowa.gov/sites/default/files/childwelfarebythenumbers2015.pdf.

Iowa Department of Human Services (DHS). (2014). Assessed Reports of Child Neglect and Abuse by Level of Finding for CY2014. Child Maltreatment Statistical Report. Child Abuse Statistics. Retrieved March 16, 2017 from http://www.dhs.iowa.gov/reports/child-abuse-statistics / http://dhs.iowa.gov/sites/default/files/Child_maltreatment_CY2014.xls.

Iowa Department of Human Services (DHS). (2014a). Iowa Child Welfare by the Numbers–Calendar Year 2014. Retrieved March 25, 2017 from http://dhs.iowa.gov/sites/default/files/childwelfarebythenumbers2014.pdf

Iowa Department of Human Services (DHS). (2014a). Differential Response System Overview 2014. Retrieved April 3, 2017 from https://dhs.iowa.gov/sites/default/files/DR_System_Overview_CY2014.pdf.

Iowa Department of Human Services (DHS). (2014b). Differential Response – Iowa, December 2014. Retrieved April 3, 2017 from https://dhs.iowa.gov/sites/default/files/Differential_Response_Conversation_Presentation.pdf.

Iowa Department of Human Services (DHS). (2014c). State of Iowa Differential Response Assessment Outcome and Service Provision. Retrieved April 1, 2017 from https://dhs.iowa.gov/sites/default/files/DR_Assessment_ Outcome_Service_Provision.pdf.

Iowa Department of Human Services (DHS). (2013a). Child Welfare Policy Update: Differential Response System, June 2013. Retrieved April 3, 2017, from http://dhs.iowa.gov/sites/default/files/DR_one_pager.pdf.

Iowa Department of Human Services (DHS). (2013b). Child Welfare Policy Update: Differential Response System, August 2013. Retrieved April 3, 2017, from http://dhs.iowa.gov/sites/default/files/8.5.13_DR_1pgr.pdf.

Iowa Department of Human Services (DHS). (2013c). Intake Screening Criteria. August 5, 2013. Draft. Retrieved April 3, 2017 from http://dhs.iowa.gov/sites/default/files/8.5.13_Intake_Screening_Criteria.pdf.

Iowa Department of Human Services (DHS). (2013d). Child Welfare Policy Update: Differential Response System, October 2013. Retrieved April 3, 2017 from http://www.dhs.state.ia.us/uploads/10.2013_DR_Policy_Stmt_3.pdf.

Iowa Department of Justice (IDJ). (2018). Human Trafficking. Retrieved August 10, 2018 from https://www.iowaattorneygeneral.gov/for-crime-victims/fighting-human-trafficking.

Iowa Department of Justice (IDJ). Office of the Attorney General. (2016). Chronicle of Women, Men, and Bystanders Killed in Domestic Violence Crimes January 1995 through September 2016. Retrieved March 16, 2017 from https://www.iowaattorneygeneral.gov/media/cms/DV_Homicide_List_93016_7EEA2E759DDC4.pdf (https://www.iowaattorneygeneral.gov/for-crime-victims/publications/).

Iowa Department of Public Health (IDPH). (2017). Adult and Child Mandatory Reporter Training. Retrieved April 3, 2017 from http://idph.iowa.gov/abuse-ed-review.

Iowa Legislature. (2017). Iowa Code 2017. Retrieved April 2, 2017 from https://www.legis.iowa.gov/docs/code/232.pdf.

Iowa Network Against Human Trafficking (INAHT). (2016). SF2258 Signed into Law July 1, 2016. Retrieved April 3, 2017 from https://iowanaht.org/sf2258-signed-into-law-july-1-2016/.

Iowa Network Against Human Trafficking (INAHT). (2016a). Iowa Department of Human Services New Child Sex Trafficking Abuse Code and Modification to Sexual Abuse Code. Retrieved April 3, 2017 from https://iowanaht.org/wp-content/uploads/Mandatory_Reporter_Release-Child_Sex_Trafficking_ and_Sexual_Abuse.pdf

National Council of Juvenile and Family Court Judges (NCJFCJ). (2016). 31 Facts for Domestic Violence Awareness Month. October 2016. Retrieved April 2, 2017 from https://www.rcdvcpc.org/resources/resource/31-facts-for-domestic-violence-awareness-month.html.

National Council of Juvenile and Family Court Judges (NCJFCJ). (1999) Effective Intervention in Domestic Violence & Child Maltreatment Cases: Guidelines for Policy and Practice. Retrieved April 2, 2017 from: https://www.rcdvcpc.org/the-greenbook.html OR https://www.rcdvcpc.org/index.php?option=com_mtree&task=att_download&link_id=71&cf_id=39.

U.S. Department of Health and Human Services (USDHHS). (2015). Child Maltreatment 2015. (Children’s Bureau, Administration on Children, Youth and Families, Administration for Children and Families.) Retrieved March 16, 2017 from https://www.acf.hhs.gov/sites/default/files/cb/cm2015.pdf also at https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment.

United States Department of State (USDOS). (2017). Trafficking in Persons Report, 2017. Retrieved August 10, 2018 from https://www.state.gov/documents/organization/271339.pdf.

Post Test

Use the answer sheet following the test to record your answers.


  • a. Has had no amendments since inception.
  • b. Was completely rewritten in the 1980s.
  • c. Had not been amended since 1978.
  • d. Was amended as recently as 2016.


  • a. Protect victims or potential victims of abuse.
  • b. Encourage parents to stop hitting children.
  • c. Punish healthcare providers who fail to report child abuse.
  • d. Create oversight of healthcare professionals and law enforcement offices.


  • a. Iowa Board of Nursing.
  • b. Iowa Department of Human Services
  • c. Catholic Charities and other religious organizations.
  • d. Iowa Department of Corrections.


  • a. All Iowa residents.
  • b. All parents and siblings of young children.
  • c. Professionals who have frequent contact with children in the course of their work.
  • d. All those who work with the public.


  • a. Two hours of approved training in the first six months of employment and two additional hours every five years.
  • b. You are a mandatory reporter by virtue of being a citizen of Iowa.
  • c. A bachelors’ degree plus five hours’ training every five years.
  • d. A professional level degree with evidence of specific training in abuse issues.


  • a. True
  • b. False


  • a. Intervene and make sure the child is safe.
  • b. Tell the perpetrator you are recording the abuse for a police report.
  • c. Contact law enforcement.
  • d. Contact DHS.


  • a. True
  • b. False


  • a. May be constrained by HIPAA regulations.
  • b. Can be charged with a felony.
  • c. Can be found guilty of both civil and criminal sanctions.
  • d. Is guilty of a simple misdemeanor and has civil liability for any damages.


  • a. True
  • b. False


  • a. When the victim is a child.
  • b. When the alleged victim is subjected to one or more of the eleven categories of child abuse.
  • c. When the abuse is the result of the acts or omissions of the person responsible for the care of the child.
  • d. All of the above.


  • a. From birth to 12 years of age.
  • b. Five years to 18 years of age.
  • c. Under the age of 18 years.
  • d. Up to the age of 21.


  • a. Men in relationships with single mothers.
  • b. People from all walks of life.
  • c. Women of child-bearing age.
  • d. Young parents with little education.


  • a. Sexual abuse.
  • b. Mental injury.
  • c. Denial of critical care.
  • d. Physical abuse.


  • a. Used for sentencing child abuse perpetrators.
  • b. Used to differentiate among perpetrators of child abuse.
  • c. Used to respond to allegations of neglect and abuse.
  • d. No longer used by Iowa.


  • a. Abuse is confirmed, not confirmed, or founded.
  • b. Abuse is founded yet inconclusive.
  • c. Abuse is confirmed, founded, or diverted.
  • d. Abuse is not confirmed and rejected.


  • a. The most important points offered in evidence.
  • b. Greater than 50% of the evidence gathered.
  • c. Not a shadow of a doubt.
  • d. Evidence that is unbelievable on its face.


  • a. True
  • b. False


  • a. No information gathered by the state on child abuse may be disclosed.
  • b. Wards of the state of Iowa are protected from publicity.
  • c. Disclosure of a listing on the abuse registry can only be made to the subject of a child abuse assessment.
  • d. Information on child abuse has top security.


  • a. Are things children do to encourage abuse.
  • b. May be both direct and indirect.
  • c. Can generally be traced to one person or factor.
  • d. Are excuses given for engaging in child abuse.


  • a. A hospital or healthcare facility that is open 24/7.
  • b. Any home that is approved by the state of Iowa.
  • c. A church or other religious facility.
  • d. A social service organization approved by the state of Iowa.

Answer Sheet

IA: Child Abuse, A Guide for Mandatory Reporters

Name (Please print your name):
 
Date:
 

Passing score is 80%


Course Evaluation

Please use this scale for your course evaluation. Items with asterisks * are required.

  • 5 = Strongly agree
  • 4 = Agree
  • 3 = Neutral
  • 2 = Disagree
  • 1 = Strongly disagree
  1. *
    Upon completion of the course, I was able to:
      • 5
      • 4
      • 3
      • 2
      • 1
      • 5
      • 4
      • 3
      • 2
      • 1
      • 5
      • 4
      • 3
      • 2
      • 1
      • 5
      • 4
      • 3
      • 2
      • 1
      • 5
      • 4
      • 3
      • 2
      • 1
      • 5
      • 4
      • 3
      • 2
      • 1
      • 5
      • 4
      • 3
      • 2
      • 1
      • 5
      • 4
      • 3
      • 2
      • 1
  2. *
    The author(s) are knowledgeable about the subject matter.
    • 5
    • 4
    • 3
    • 2
    • 1
  3. *
    The author(s) cited evidence that supported the material presented.
    • 5
    • 4
    • 3
    • 2
    • 1
  4. *
    This course contained no discriminatory or prejudicial language.
    • Yes
    • No
  5. *
    The course was free of commercial bias and product promotion.
    • Yes
    • No
  6. *
    As a result of what you have learned, do you intend to make any changes in your practice?
    • Yes
    • No
  7. If you answered Yes above, what changes do you intend to make? If you answered No, please explain why.
  8. *
    Do you intend to return to ATrain for your ongoing CE needs?
    • Yes, within the next 30 days.
    • Yes, during my next renewal cycle.
    • Maybe, not sure.
    • No, I only needed this one course.
  9. *
    Would you recommend ATrain Education to a friend, co-worker, or colleague?
    • Yes, definitely.
    • Possibly.
    • No, not at this time.
  10. *
    What is your overall satsfaction with this learning activity?
    • 5
    • 4
    • 3
    • 2
    • 1
  11. *
    Navigating the ATrain Education website was:
    • Easy.
    • Somewhat easy.
    • Not at all easy.
  12. *
    How long did it take you to complete this course, posttest, and course evaluation?
    • 60 minutes (or more) per contact hour
    • 50-59 minutes per contact hour
    • 40-49 minutes per contact hour
    • 30-39 minutes per contact hour
    • Less than 30 minutes per contact hour
  13. I heard about ATrain Education from:
    • Government or Department of Health website.
    • State board or professional association.
    • Searching the Internet.
    • A friend.
    • An advertisement.
    • I am a returning customer.
    • My employer.
    • Other
    • Social Media (FB, Twitter, LinkedIn, etc)
  14. Please let us know your age group to help us meet your professional needs.
    • 18 to 30
    • 31 to 45
    • 46+
  15. I completed this course on:
    • My own or a friend's computer.
    • A computer at work.
    • A library computer.
    • A tablet.
    • A cellphone.
    • A paper copy of the course.

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