Cabinet for Health and Family Services Department for Community Based Services Division of Protection and Permanency Search Table of Contents
7H CHILD FATALITY OR NEAR FATALITY 7H.1 CHILD FATALITY OR NEAR FATALITY GENERAL GUIDELINES 7H.2 CHILD FATALITY OR NEAR FATALITY INVESTIGATIONS 7H.3 OUT-OF-HOME CARE (OOHC) CHILD FATALITY OR NEAR FATALITY
SOP 7H R. 11/15/06 CHILD FATALITY OR NEAR FATALITY
INTRODUCTION: The Division of Protection and Permanency (DPP) investigate all reports of child fatalities or near fatalities, defined by KRS 600.020 (37) as an injury that, as certified by a physician, places a child in serious or critical condition that occur due to alleged abuse or neglect by a: 1. Parent; 2. Guardian; or 3. Other person exercising custodial control or supervision of the child; even if there are no remaining children in the home; except if the child is in a facility operated by the Department of Juvenile Justice. A child fatality or near fatality in a DJJ-operated facility is referred to the Justice Cabinet for investigation under a Memorandum of Understanding between DJJ and the Cabinet for Health and Family Services. In order to assure coordination of appropriate information dissemination, all media inquiries are referred to the Office of Communications at 502-564-6180.
SOP 7H.1 R. 11/1/08 CHILD FATALITY OR NEAR FATALITY GENERAL GUIDELINES
COA STANDARDS: ● NA
LEGAL AUTHORITY: KRS 211.680-211.686 Review of Child Fatalities KRS 600.020 Definitions for KRS Chapters 600 to 645 KRS 620.050 Immunity for good faith actions or reports 922 KAR 1:420, Child fatality or near fatality investigations
PROCEDURE: 1. Receiving and Assessing the Report:
1 (a)Protection and Permanency upon receiving a report of a child fatality or near fatality: (a)Determine if the referral meets criteria as outlined in 7A.2 Acceptance Criteria; (b)Conduct an investigation when the referral meets criteria as outlined in SOP 7B CPS Investigation or FINSA to: (1)Assess whether the fatality or near fatality was caused by abuse or neglect; (2)Assess risk to any child(ren) in the home (including survivor of a near fatality);and (3)Protect any children remaining in the home. (b)If Protection and Permanency staff learn through the media of a child fatality or near fatality due to suspected abuse or neglect and have not received an actual referral, they may contact law enforcement or the coroner for additional information. If the information received meets acceptance criteria, Protection and Permanency conducts and investigation. (c) In cases where abuse or neglect is substantiated and has resulted in a fatality or near fatality and there has been a previous FINSA or investigation on the child or family, the case is considered to have previous Protection and Permanency involvement and is required per KRS 620.050(12) to have an internal review. (Link to SOP 7H.2 Child Fatality or Near Fatality Investigation) 2. Notification: (a)The SSW notifies the Service Region Administrator (SRA) or, in his or her absence the SRA designee, on all fatalities or near fatalities involving: (a)Suspected child abuse or neglect; (b)Current open cases for ongoing services; (c) Cases that have had ongoing services within the last twelve (12) months; (d)Any open investigation; or (e)Any death of a child in the custody of the Cabinet. (b)Upon receiving a report of a child fatality that meets criteria for an investigation, the SSW: (1)Notifies the SRA or, in his or her absence the SRA designee, immediately (even at night and on weekends) of the: (A) Name and age of victim; (B) Names of parents or caretaker and alleged perpetrator; (C) Known circumstances around the fatality or near fatality (D) Description of physical injuries or medical condition of the child at the time of fatality or near fatality; (E) Names, ages and location of additional children in the family and any actions taken for their safety; (F) Description of Protection and Permanency history with the family or caretaker, if any; (G) Actions taken by Protection and Permanency to date and future actions to be taken, including initiation of an investigation; and (H) Involvement of other professionals in the case; and (2)Notifies law enforcement immediately by telephone (unless law enforcement was the reporting source). Law enforcement, the Commonwealth Attorney and/or the County Attorney are notified of all child fatalities allegedly due to
2 abuse or neglect in writing using the DPP-115, Confidential Suspected Abuse, Neglect, Dependency or Exploitation Reporting Form. (c)The region notifies the Child Fatality Specialist by completing/submitting the Notice of Child Fatality/Near Fatality form by fax at (502) 564-3096 or by email ([email protected]), within twenty-four (24) hours, exclusive of weekends and holidays on all fatalities or near fatalities involving: (1) Suspected child abuse or neglect; (2) Current open cases for ongoing services; (3) Cases that have had ongoing services within the last twelve (12) months; (4) Any open investigation; or (5) Any death of a child in the custody of the Cabinet. (6) A child fatality or near fatality in a DJJ-operated facility is referred to the Justice Cabinet for investigation under a Memorandum of Understanding between DJJ and the Cabinet for Health and Family Services. (d)If a referral is received regarding a child with a disability who is potentially being denied medically beneficial treatment or being deprived of nourishment by caretakers, the regional medically fragile liaison and the DPP, Medical Support Section of Central Office is consulted at (502) 564-2136. (e)The SSW or Regional Office notifies the Cabinet for Environmental and Public Protection Division of Public Protection and Advocacy, when a child is a fatality or near fatality as a result of alleged abuse or neglect and the: (1)Child is identified as a Protection and Advocacy client; and (2)Perpetrator is in a caretaker role. 3. De-Briefing Protection and Permanency staff on responses to trauma regarding fatality and near fatality cases: (a)Trauma is inherent in child fatality and near fatality investigations and each service region will follow procedures outlined in SOP 1B.18 - De-Briefing Protection and Permanency (DPP) Staff on Reaction and Emotional Responses to Trauma to assist Protection and Permanency staff in coping with reactions and emotional responses to trauma.
SOP 7H.2 R .11/1/08 CHILD FATALITY OR NEAR FATALITY INVESTIGATIONS
COA STANDARDS: ● NA
LEGAL AUTHORITY: KRS 211.680-211.686 Review of Child Fatalities KRS 600.020 Definitions for KRS Chapters 600 to 645 922 KAR 1:420, Child fatality or near fatality investigations
PROCEDURE:
3 1. Reports (a)The SSW follows procedures outlined in SOP 7H.1 Child Fatality or Near Fatality General Guidelines, as well as, the following additional procedures. (b)All reports that allege that a child fatality or near fatality has occurred as a result of alleged abuse or neglect are accepted as Investigations as outlined in SOP 7A.2 Acceptance Criteria. (c)In cases where the fatality or near fatality is abuse or neglect related and the child is in out of home care, the SRA or designee follows SOP 7H.3 for notification of the birth family and committing court. 2. Assigning Investigative Staff: (a)The SRA or designee assumes responsibility for assigning staff to investigate the child fatality or near fatality that have had no prior involvement with the family. Prior involvement with the family (including all CPS Track 1-4, APS, or Status cases) includes staff that: (1) Have completed a previous investigation involving the family; (2) Are currently assigned as an ongoing case manager for the family; or are currently investigating the child or family or; (3) Have supervised an investigation or ongoing case involving the family. (b)Staff assigned to investigate, supervise or consult on the investigation may be in the same region. However, the assigned staff may not have had prior involvement with the family. If the investigation is initiated by a SSW or FSOS with prior involvement with the family and did not realize it until after initiation, the FSOS notifies the SRA or, in his or her absence the SRA designee. The SRA or in his or her absence the SRA designee reassigns the investigation, as soon as possible, upon notification. 3. Securing and Updating an Existing Case Record: (a)In cases where there is an open case with the family, within one (1) working day of receipt of the report of child fatality or near fatality the SRA or, in his or her absence, the SRA designee assigns staff to secure the official case record from the appropriate DCBS office, including control access of the TWIST case and any official documents completed with the family during a pending investigation. A copy may be left in the local DCBS office as needed to provide ongoing services to the family and/or to complete documentation on the case. (b)The official case record is delivered to the assigned FSOS and/or SSW responsible for the: (a)Child Fatality or Near Fatality Investigation; and (b)Integrity of the official case record, until the investigation is approved. (c)In cases where there is a pending CPS Investigation or FINSA with the family at the time of receipt of the Child Fatality or Near Fatality Investigation, the SSW and FSOS involved in the case: (1)Immediately cease any further assessment on the pending CPS Investigation or FINSA; (2)Document all efforts based on information known prior to receipt of the child fatality or near fatality in TWIST, within three (3) working days of the report date of the child fatality or near fatality; and (3)Explain in the narrative of the assessment that the assessment was ceased based on a new report alleging a child abuse or neglect related child fatality or near fatality.
4 (d)In ceasing the assessment based on a new report of child fatality or near fatality the SSW enters all information known up to the point of notification of the child fatality or near fatality. Based on that information the SSW and the FSOS make a determination of findings: (1)To substantiate or unsubstantiate an investigation; or (2)That the family does or does not need services during a FINSA. The SSW notes in the case record, TWIST, CQA, etc. that the referral has been ceased due to the receipt of a new investigation on a child fatality or near fatality. If the pending investigation involves alleged sexual abuse the region contracts Central Office (C0) for consultation on a case by case basis. (e) If there is an ongoing APS Investigation with the family at the time of receipt of the Child Fatality or Near Fatality Investigation, the pending APS investigation proceeds as appropriate. If the APS investigation is complete, however the documentation is not, the SSW and FSOS involved in the case completes within three (3) working days of the report date of the child fatality or near fatality: (a)All documentation; and (b)Updates the case record in TWIST. (f) If there is an open case for services with the family at the time of receipt of the Child Fatality or Near Fatality Investigation, the SSW and FSOS involved in the case, within three (3) working days of the report date of the child fatality or near fatality: (a)Completes all documentation; and (b)Updates the case record in TWIST. (g) If the fatality or near fatality occurred in a DCBS resource home the official case record for the provide case is secured within one (1) working day of receipt of the report of child fatality or near fatality as outlined in procedure number seven (7). The SSW and FSOS involved in the case, within three (3) working days of the report date of the child fatality or near fatality: (a)Completes all documentation; and (b)Updates the case record in TWIST. (h) All service recordings, CQA and investigative results on pending CPS referrals are submitted by the SSW and FSOS within three (3) working days of the report date of the child fatality or near fatality, but are not finalized or approved in TWIST until reviewed and authorized by the: (a)Regional attorney for the Office of Legal Services; (b)SRAA or SRCA; and (c) SRA. 4. The Fatality Investigation and Documentation: (a) When completing a fatality or near fatality investigation, the SSW follows investigative guidelines set forth in SOP 7B, as well as, the following procedures. (b) If child abuse or neglect is suspected, the SSW determines the safety of any surviving children, including other foster children and natural children through immediate assessment to assure their safety. The assessment includes: (1)Arranging for physical examinations to check for any current injuries to the surviving children, if indicated; (2)Determining whether there has been any history of prior abuse or neglect to the children or other family members by the alleged perpetrator;
5 (3)Interviewing the children separately and in a safe environment to assess present emotional condition and to determine to what extent they may have witnessed family violence; (4)Observing interaction between parent or caretaker and children; (5)Discussing parent or caretaker’s own family history; (6)Making collateral contacts with neighbors, schools and extended family; (7)Determining whether the surviving children were present during the time frame of the deceased child’s injuries and therefore may have witnessed what occurred; (8)Referring immediately to mental health counseling, if appropriate; (9)Developing immediately a Prevention Plan for siblings, pending the completion of the investigation, if they remain in the home; and, (10) Checking TWIST records for a history of child abuse/neglect, court records for a history of domestic violence and criminal records for alleged perpetrator and other adults in the home. (c) If a coroner refuses to request an autopsy and the SSW asserts the need for an exam, the SSW consults with the Director of Protection and Permanency regarding how to proceed. The Office of Legal Services (OLS) may also be consulted. KRS 72.025 and KRS 72.405 mandate that the coroner require a post-mortem examination, which may include an autopsy, on the death of any child where the cause of the death appears to be violence, child abuse, suicide, drugs, SIDS or a variety of other unexpected or unexplained causes. (d) The SSW interviews first responders to the fatality or near fatality including but not limited to law enforcement, Emergency Medical Staff as collaterals in the fatality or near fatality investigation. (e) Information gathered during the course of an investigation including prior DPP involvement with the family can be shared with the medical examiner if requested. (f) The SSW is encouraged to participate in Local Child Fatality Response Teams to assist in cross communication and sharing information between different agencies. (g) The SSW obtains all medical records for the child and seeks consultation from the Fatality Nurse Administrator regarding the injuries to the child fatality or near fatality both chronic and acute as well as siblings when indicated. (h) The SSW makes every effort to interview the alleged perpetrator, but does not interfere with the investigation by law enforcement. If the perpetrator refuses to be interviewed, this is clearly documented, as are reasons for delays in the investigation or interview with the perpetrator. (i) Upon completion of a fatality or near fatality investigation, the regional office provides case consultation and approval of findings prior to the finalization of the assessment in TWIST. Regional consultation is documented in the assessment. An abbreviated assessment is never utilized in a child fatality or near fatality. 5. The Internal Review Process: (a)The SRA or, in his or her absence the SRA designee, schedules an internal child fatality or near fatality review meeting, within sixty (60) calendar days of receipt of the report of child fatality or near fatality when the Cabinet has substantiated
6 abuse or neglect and had prior involvement with the child and/or family to discuss: (1)Previous DPP involvement; (2)The current investigation; (3)Recommendations for the family; (4)Existing practice to identify areas for improvement; and (5)Opportunities for staff training and development. (b)Attendance in the internal child fatality or near fatality review meeting is required of the: (1)SSW investigating the child fatality or near fatality; (2)FSOS; (3)Regional Attorney; (4)SRA or designee; (5)SRAA/SRCA; (6)SSW/FSOS previously involved in the case, when applicable; (7)The Central Office Child Fatality or Near Fatality Specialist; and (8)(Optional) The Child Fatality or Near Fatality Nurse Administrator. Other agency staff may attend this review at the discretion of the SRA and/or Regional Attorney. The Central Office Child Fatality or Near Fatality Specialist is advised of the date and time of the meeting and travels to the region to attend or participates via conference call when attendance is not possible. (c) Within ten (10) working days of the child fatality or near fatality internal review meeting, recommendations gleaned from the review are submitted as “Confidential Attorney Client Privileged Correspondence” to the Child Fatality Specialist who will distribute to the following persons: (1) Cabinet’s, General Counsel; (2) Director of Protection and Permanency; and (3) Director of Service Regions. This Confidential Attorney Client Privileged Correspondence is not placed in the official case record.
SOP 7H.3 R. 11/15/06 OUT-OF-HOME CARE (OOHC) CHILD FATALITY OR NEAR FATALITY
COA STANDARDS: ● NA
LEGAL AUTHORITY: KRS 211.680-211.686 Review of Child Fatalities KRS 600.020 Definitions for KRS Chapters 600 to 645 922 KAR 1:420, Child fatality or near fatality investigations
PROCEDURE: 1. Notification of Family and Court
7 (a) The Service Region Administrator (SRA) or designee appoints a SSW or supervisor to immediately notify the child’s parents of the fatality or near fatality when the: (1)Child is in the custody of the Cabinet and placed out of the birth parent’s home in a: (A) Foster home, (B) Cabinet facility, (C) Psychiatric unit/hospital, or (D) Private child care facility; and (b) Parent’s parental rights are intact. The notification is recommended to be a personal visit. When parental rights have been terminated and there has been ongoing contact or other special circumstances, and a finalized adoption has not occurred, the decision to notify biological parents may be made by the SRA or designee. All efforts to notify parents are to be documented in the file. (c)When a child is in the custody of the Cabinet and a fatality or near fatality occurs regardless of circumstances, the Notice of Child Fatality/Near Fatality form is completed and faxed to the Director of the Division of Protection and Permanency, within twenty-four (24) hours, exclusive of holidays and weekends at (502) 564-3096. (d)The SSW notifies in writing, the judge of the court of jurisdiction and the Guardian Ad Litem in all cases before the court when there is a child fatality or near fatality: (1)As soon as practicable; but (2)No later than three (3) working days after receipt of the report. 2. Funeral Arrangements (a) When there is a child in the custody of the Cabinet, the SSW explores with the birth parents their ability to accept financial responsibility for the funeral. All personal and family resources, including the child’s Trust Fund and insurance in the child’s name, are to be exhausted prior to approval of Cabinet funds for funeral and burial expenses. Funeral arrangements remain the responsibility of the birth parents whenever possible unless parental rights have been terminated or a decision is made by the SRA or designee that the Cabinet will assume that responsibility. The selection of a funeral home, mortician, casket, and burial lot are to be based on estimates of cost that are reasonable and on consideration of the choice of the birth parents. The SSW may purchase clothing for burial or the birth family, foster family, extended family, etc. may provide clothing. The SSW may select flowers, billing the Department and forwarding the invoice to the regional billing clerk. Arrangements for religious services may be made with a clergyman of the birth parents’ faith. If the birth parents’ faith is unknown, a clergyman of the foster parents’ faith may conduct services. (b) When a child is in the custody of the Cabinet and their death is imminent the SSW pre-plans the funeral with the birth parents, and/or caregiver if the birth parents are not involved, to include: (1) Contacting funeral homes to get cost estimates for a pre-planned funeral, which include the burial plot and opening of the grave; (2) Submitting to the FSOS:
8 (A) A Request for Approval of Special Expense (Sample Form) for the funeral to the FSOS for review, outlining the specific needs and circumstances pertinent to the request; and (B) Copies of funeral cost estimates. (c)The FSOS upon review submits the Request for Approval of Special Expense and copies of the funeral cost estimates to the SRA for approval; (d)Upon SRA approval the SSW files the Request for Approval for Special Expense and the funeral cost estimate of the funeral home selected in the child’s case record; (e)The SSW notifies the birth parents and/or caregiver, if the birth parents are not involved, to inform the approved funeral home and proceed with the funeral arrangements; and (f) Invoices are forwarded upon receipt, along with the special expense approval from the SRA, to the regional billing clerk for processing as normal. (g)When a child is in the custody of the Cabinet and death occurs without the opportunity for a pre-planned funeral the SSW follows the same procedures as outlined in bullet point number 2(a) above for funeral arrangements and payment.
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