Report Title:

Child Abuse or Neglect; Review by DHS for Medical Consultation

 

Description:

Requires the department of human services to review each case of reported child abuse or neglect to ascertain if a medical referral should be made to obtain a definitive medical opinion on abuse or neglect. (SD2)

THE SENATE

S.B. NO.

2150

TWENTY-FIRST LEGISLATURE, 2002

S.D. 2

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to child abuse or neglect.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that child maltreatment is a major public health problem in our society. In 1998, over two million eight hundred thousand children were reported to child protective services agencies across the country, representing a ninety-eight per cent increase since 1986. Approximately thirty per cent of victims of serious physical abuse have evidence of prior episodes of abusive injuries. In addition, recidivism, or re-abuse after child protective services investigation, has been reported at over fifteen per cent. The result of this lack of recognition of abuse is the unnecessary suffering and death of our nation’s children.

Between 1996 and 1999 on Oahu, the number of reports made to child protective services, which operates as a unit of the department of human services, that received investigation increased by forty-five per cent to three thousand two hundred thirty-seven. At the same time, child abuse has emerged as an area of specialized expertise within pediatrics; this area of expertise is referred to as forensic pediatrics. There is a rapidly growing body of knowledge in the field; the number of published articles in the medical literature on child abuse has risen seventy per cent in the last fifteen years. National organizations have been formed to promote training and education in this area. Due to the increase in medical knowledge in the field of child abuse, the investigation of children who are reported to child protective services has become more complex. The accurate diagnosis of child abuse relies on the joint work of both medical and social service specialists in the field of child abuse. Recognizing the need for collaboration, centers are being established throughout the country to provide forensic pediatric consultation to child protective services agencies.

In Hawaii, state funding has limited the availability of medical consultation in the area of child abuse. Currently, only two groups of children receive child abuse medical evaluations during their child protective services investigation:

(1) The seriously injured children who are hospitalized;

(2) The small number of children who present to child protective services with a history of acute (within the last seventy-two hours) sexual abuse.

Despite the availability of medical experts in this field, a child abuse physician examines only three per cent of the children being investigated by child protective services. The lack of such medical evaluation results in injuries being improperly documented and missed altogether.

The purpose of this Act is to require the department of human services to review every reported case of child abuse to determine if a referral to a qualified medical specialist is necessary for a medical opinion.

SECTION 2. Chapter 350, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§350- Medical referral for opinion on abuse or neglect. (a) The department shall review every report under section 350-1.1 to determine whether a referral to a physician is necessary for a definitive medical opinion on whether the injury or condition is a result of child abuse or neglect. If the department determines that a referral should be made, the department shall immediately refer the child for an opinion from a physician experienced in diagnosing child abuse or neglect.

(b) For purposes of this section, informed consent shall not be required from the legal or physical custodian of the child or from the department, if the child is under the placement responsibility of the department."

SECTION 3. Section 350-2, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) Upon receiving a report concerning child abuse or neglect, the department shall proceed pursuant to chapter 587, section 350- , and the department's rules."

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $ , or so much thereof as may be necessary for fiscal year 2002-2003, for medical referrals.

The sum appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 5. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval; provided that section 4 shall take effect on July 1, 2050.