HomeMy WebLinkAbout20101368.tiff RESOLUTION
RE: APPROVE PROTOCOL OF SERVICES AND COOPERATING TEAM MEMBER
AGREEMENT AND AUTHORIZE CHAIR TO SIGN - A KID'S PLACE CHILD
ADVOCACY CENTER
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with the Protocol of Services from A Kid's
Place Child Advocacy Center, to Weld County, on behalf of the Department of Human Services,
and a Cooperating Team Member Agreement among the County of Weld, State of Colorado, by
and through the Board of County Commissioners of Weld County, on behalf of the Department
of Human Services, the Weld County Sheriffs Office, and the District Attorney's Office, A Kid's
Place Child Advocacy Center, the Greeley Police Department, the Evans Police Department,
North Colorado Family Medicine, Monfort Children's Clinic, North Range Behavioral Health,
LaSalle Police Department, the Dacono Police Department, the Platteville Police Department,
the Windsor Police Department, the Fort Lupton Police Department, the Kersey Police
Department, the Gilcrest Police Department, the Johnstown Police Department, the Lochbuie
Police Department, the Eaton Police Department, the University of Northern Colorado (UNC)
Police Department, the Firestone Police Department, the Frederick Police Department, the Ault
Police Department, and the Milliken Police Department, commencing upon full execution, with
further terms and conditions being as stated in said Protocol of Services and agreement, and
WHEREAS, after review, the Board deems it advisable to approve said Protocol of
Services and agreement, copies of which are attached hereto and incorporated herein by
reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Protocol of Services from A Kid's Place to the County of Weld, State
of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of
the Department of Human Services, the Weld County Sheriffs Office, and the District Attorney's
Office, and the Cooperating Team Member Agreement among the County of Weld, State of
Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the
Department of Human Services, the Weld County Sheriffs Office, and the District Attorney's
Office, and A Kid's Place Child Advocacy Center, the Greeley Police Department, the Evans
Police Department, North Colorado Family Medicine, Monfort Children's Clinic, North Range
Behavioral Health, LaSalle Police Department, the Dacono Police Department, the Platteville
Police Department, the Windsor Police Department, the Fort Lupton Police Department, the
Kersey Police Department, the Gilcrest Police Department, the Johnstown Police Department,
the Lochbuie Police Department, the Eaton Police Department, the University of Northern
Colorado (UNC) Police Department, the Firestone Police Department, the Frederick Police
Department, the Ault Police Department, and the Milliken Police Department be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said Cooperative Team Member Agreement.
1 o r i c *o 5usc nT l NS) 2010-1368
ac - to HR0081
PROTOCOL OF SERVICES AND COOPERATING TEAM MEMBER AGREEMENT AND
AUTHORIZE CHAIR TO SIGN -A KID'S PLACE CHILD ADVOCACY CENTER
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 23rd day of June, A.D., 2010.
BOARD OF COUNTY COMMISSIONERS
WELD COUN Y re ORADO
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Date of signature: 7/i4/10
2010-1368
HR0081
MEMORANDUM
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frDATE: June 22, 2010
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TO: Douglas Rademacher, Chair, Board of Coun Comr�}i si rs
W� O FROM: Judy A. Griego, Director, Human Services art nt
COLORADO Protocol of Services and Cooperating Team Member
Agreement between the Weld County Department of
Human Services and A Kid's Place
Enclosed for Board approval is the Protocol of Services and Cooperating Team Member Agreement
between the Department and A Kid's Place. This Agreement and Protocol of Services were
presented at the Board's June 21, 2010, Work Session.
The Protocol of Services for A Kid's Place Child Advocacy Center (CAC) was developed as a
component of the Weld County Child Abuse Coalition's Child Abuse Protocol.
The Member Agreement is non-financial and is a requirement for State Certification of A Kid's Place.
The Agreement is for the coordination of the team approach to investigations involving but not
limited to (a) medical personnel, (b) law enforcement personnel, (c) child protective services, (d)
prosecutors from the District Attorney's Office, and (e) mental health; to establish and maintain a
nurturing, child-focused setting in which investigations can be done;to centralize resource materials
for professionals and families;to enhance professional skills necessary to effectively respond to child
abuse through training, education and collaboration; to participate in activities which provide a
comprehensive, multidisciplinary response to child abuse; to provide families with support and
necessary referrals.
If you have questions, please give me a call at extension 6510.
2010-1368
A Kid's Place
Cooperating Team Member Agreement
Mission
The mission of A Kid's Place is to provide advocacy and support for abused or neglected
children by advancing coordinated investigations, prosecution and victim services.
Vision
To advance the community response to child abuse through coordinated investigation,
prosecution, and victim's service efforts.
Purpose
1. Coordination of the team approach to investigations involving but not limited to (a)
medical personnel, (b) law enforcement personnel, (c) child protective services, (d)
prosecutors from the District Attorney's Office, and (e) mental health;
2. To establish and maintain a nurturing, child-focused setting in which investigations can
be done;
3. To centralize resource materials for professionals and families;
4. To enhance professional skills necessary to effectively respond to child abuse through
training, education and collaboration;
5. To participate in activities which provide a comprehensive, multidisciplinary response to
child abuse;
6. To provide families with support and necessary referrals.
Scope of Services
• Coordination of forensic interviews including the use of an in-house forensic interviewer
• The use of A Kid's Place facility both in Greeley and in south Weld County
• Video and audio taping of all interviews
• Coordination of medical examinations at the request of law enforcement
• Appropriate referrals and follow-up on referrals for children and families at the request of
law enforcement
• Coordination of monthly case review staffings for the District Attorney's Office.
A Kid's Place Child Advocacy Center
Cooperating Team Agreement
THIS AGREEMENT is made by and between the agencies and individuals involved in A Kid's
Place.
The purpose of this agreement is to enhance the ability of agencies, organizations, and
individuals to implement coordinated efforts in investigation of child abuse and neglect.
Adherence to these policies and procedures should not be construed as a creation of a higher
level standard of safety or care with respect to any civil claim or criminal matter. Therefore, it is
acknowledged that the UNDERSIGNED participating agencies and individuals agree to the
following philosophical and policy statements supporting A Kid's Place:
We recognize the trauma that occurs to children and families involved in child abuse and neglect.
In order to reduce that trauma, the Mandated Reporting Protocol Committee (formerly the Weld
County Child Abuse Coalition) and A Kid's Place have developed a cooperative team approach
to conducting child abuse and neglect investigations.
To facilitate this team approach, A Kid's Place enhances the cooperation and coordination of
those involved in the protection of children. A Kid's Place offers a safe, child focused place to
centralize the investigation and prosecution efforts for child victims of abuse.
Each of the undersigned agencies and individuals has specific responsibilities for the protection
of victims and the investigation of child abuse. These responsibilities are outlined in the Weld
County Child Abuse Coalition's Protocol. Use of A Kid's Place does not alter specific role
responsibilities.
We believe that by functioning as a multi-disciplinary team, we are providing Weld County
children and families with a more positive approach that is effective in the timely resolution of
specific cases and the ultimate resolution of the larger social issue.
All parties are responsible for adhering to the Colorado Children's Code and the Colorado
Criminal Statutes.
All parties understand that this agreement, in no way, shall be construed to:
• limit law enforcement's authority to investigate reports of child abuse and neglect;
• limit the Department of Human Services authority to assess, respond, and investigate
reports of child abuse and neglect nor limit DHS authority to make all subsequent
decisions on behalf of children placed in protective custody;
• dictate medical practitioner's procedures for medical examinations, or limit their
authority or responsibility for medical care.
Therefore, to better protect and serve the children of Weld County, we agree to support the
concept, philosophy, policies, procedures and continued development of A Kid's Place.
Members of A Kid's Place multidisciplinary team agree to:
• Utilize A Kid's Place for interviews of child victims of sexual abuse and severe
physical abuse. No suspected perpetrators are allowed at A Kid's Place.
• Be signatories of The Weld County Child Abuse Protocol, which outlines the best
A Kid's Place Child Advocacy Center
Cooperating Team Agreement 2
• Be signatories of The Weld County Child Abuse Protocol,which outlines the best
practices in identifying,reporting, investigating and treating child abuse in Weld
County.
• Send investigators to attend monthly case review staffings with the District
Attorney's Office.
• Attend or send representatives to investigative training offered through A Kid's Place
as needed.
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A Kid's Place Child Advocacy Center
Cooperating Team Agreement 3
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Procedures at A Kid's Place Child Advocacy Center
Address: 2540 11th Avenue
Greeley, CO 80631
Phone: (970)353-5970
Fax Number: (970)353-9577
After Hours Cell Phone (970) 405-3551
Hours of Operation
Staffed Hours: We are available between the hours of 8 and 5pm Monday through
Thursday and 8 to 4pm Friday when the phone will be answered by A Kid's Place staff.
Voice mail will take messages after hours. A Kid's Place Staff can also be reached after
hours via a cell phone(970)405-3551
Scheduling an Interview
✓ Provide staff person with information for A Kid's Place Intake Form.
✓ After the interview, sign and/or fill in the white Intake Form and leave it with staff. Take
DVDs with you.
✓ There is a conference room at the child advocacy center that is available to use when talking
to parents or other team members.
Billin
The cost to Agency is per year,billed quarterly. You will be
invoiced by A Kid's Place. There is no charge for DVD recordings.
Medical exams will be billed separately to each Law Enforcement Agency by the medical
provider.
A Kid's Place Child Advocacy Center
Cooperating Team Agreement
BOARD OF COUNTY COMMISSIONERS
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Jud . Griego ' ector
A Kid's Place Child Advocacy Center
Cooperating Team Agreement
A Kid's Place Child Advocacy Center
Greeley, Weld County Colorado
Protocol of Services
I. OVERVIEW
This protocol of services for A Kid's Place Child Advocacy Center(CAC)was developed as
a component of the Weld County Child Abuse Coalition's Child Abuse Protocol. The
goal of the Protocol Project is to facilitate an integrated, interdisciplinary team approach
to reporting, investigating and treating child abuse cases. Our ultimate goal is to
enhance the communication between individuals and agencies within the child abuse
system resulting in cooperative, complementary decision making.
The latest revision of the Child Abuse Protocol was in 2007 and we are currently in the
revision process for 2010.
II. MISSION STATEMENT
The mission of A Kid's Place is to provide advocacy and support for abused and
neglected children by advancing coordinated investigations, prosecution and victim
services.
III. USE OF THE CHILD ADVOCACY CENTER
In the 19th Colorado Judicial District, all cases of child abuse are reported to local law
enforcement and/or the Department of Human Services depending upon the nature
of the abuse. It is the responsibility of the agencies to respond to reports and to
include other agencies as necessary and in accordance with the Weld County Child
Abuse Protocol. It is also the responsibility of the responding agency to coordinate
the time and place of the interview with the family or non-offending parent. We do
not knowingly allow alleged perpetrators to be present during the child's interview
at the CAC.
A Kid's Place encourages all agencies to use the CAC when interviewing children
involved in the following situations:
• sexual and physical abuse investigations;
• situations where the child is a witness to a violent act;
• when a child must be interviewed during a crime investigation (witness to
murder, domestic violence, etc.); and
• when a child must be interviewed to determine his/her safety.
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In contrast to the police department, sheriff's office, or school situation, the CAC
provides a private, child friendly environment with the goal of putting the child at
ease.This type of environment increases the probability of more complete responses
from the child and a better determination of the facts for the investigator.
Process to Use CAC: In order to schedule time for the use of an interview room, a
team member should call the CAC at(970) 353-5970. If it is during business hours and
a staff person does not answer, the caller should leave a voice message and the CAC
will call to confirm the requested time.
The investigator/caseworker will need to provide the following information to the
CAC when scheduling an interview time:
• Date and time of requested interview
• Number of child/ren to be interviewed
• Names of the child/ren to be interviewed
• Ages of child/ren to be interviewed
• Names of additional investigators/caseworkers to be present
• Reason for interview
• Any disabilities or special needs the child/ren or family may have
• If an interpreter will be needed to talk with the families
• Name(s) and age(s) of parent(s)
• Name(s) of individual(s) bringing child to the CAC
• Relationship of person(s) bringing child to the CAC
• Name(s) and age(s) of alleged offender(s)
• Relationship of the offender to victim
• Law enforcement case #
• Previous forensic interviews of victim
The CAC has available any materials necessary for complete and thorough interviews
including anatomically correct dolls,TV/VCR, drawing materials, anatomical drawings,
Truth or Lie, etc. Anatomical dolls should only be used by forensic interviewers that
have received training in their use and only as an interview aid and not an
investigative or forensic tool.
We suggest the number of adults in the interview room should be limited to two (2)
Other team members may observe the interview through closed circuit television
Interviewers must always consider who is looking through the close circuit television.
Parents will not be allowed to watch the interview in progress. Parents may be
potential witnesses and/or may hear very upsetting details not previously revealed.
Only in an extreme and highly unusual case involving a child who is at high risk of
continuing harm and who otherwise refuses to be interviewed may law enforcement
or the Department of Human Services allow a parent, other caregiver, or therapist to
remain in the interview room.Although welcome at the CAC to provide support,
2
ministers, relatives, siblings, boyfriends or girlfriends, and all others not a party to the
case will not be allowed to view the interview while in progress.
Offender forms are made available and must be filled out by the lead investigator
following the interview. These forms are used in tracking cases, providing statistics,
as well as, information regarding CAC utilization.The CAC Program Coordinator will
assist with this process.
We strongly encourage all law enforcement conducting interviews to wear regular
street clothes.This helps lessen the anxiety of the child during the interview process.
Law enforcement will not be allowed to wear their weapon during an interview.
Weapons should be locked in vehicles or stored in the locked fire safe in the
Observation Room at A Kid's Place.
Use of the CAC After Hours: In an after hours emergency, agencies can reach a staff
person at(970) 405-3551 for an interview. CAC staff will make a note on the Intake
Sheet if a medical exam is required. CAC staff will schedule the exam and notify
parties of the time and date on the next working day.
Video-recording Capability: The CAC is equipped with two (2) interview rooms with
video-recording capability. Closed circuit televisions are available to professionals
who must view the interview during its progress. The Colorado Children's Code states
in Subsection 19-3-308.5 Paragraph (a) "interviews concerning reports of sexual child
abuse are strongly encouraged to be video-recorded" Video-recording can potentially
limit the number of times a child must be interviewed, as well as, the number of
people who are present during the interview.Video-recordings are valuable
assessment tools that assist in the search for the truth.
The following are advantages to video-recordings;
• Decreases the need for multiple interviews and is, therefore, less stressful
for the child.
• Allows the interviewer to focus attention on the child without intimidating
and distracting him or her.
• Allows the interviewer to review the DVD at a later date when clarification is
needed regarding information.
• Allow professionals to have a permanent, viewable record of the
conversation.
• Allows the interviewer to assess his/her own abilities and techniques of
interviewing.
Video-recording of the interview will be handled by the trained staff of the CAC. New
DVDs are provided by the CAC. All DVDs made at the CAC are the property of the
agency conducting the interview. DVDs produced by a law enforcement investigation
are placed into evidence by the police officer at their respective stations.
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IV. MDT PROTOCOL
The CAC has a Cooperating Team Agreement signed by all 17 Law Enforcement Chiefs in
the county, the Department of Human Services, Mental Health and medical providers
and is updated for signatures each time an Agency head changes. A Kid's Place is a lead
member of the Weld County Child Abuse Protocol Committee which includes signed
agreements with the above listed plus treatment providers, school districts, hospitals
and newspapers focusing on how child abuse is handled in our county from the initial
report through the investigation, treatment and prosecution. This 30o page Protocol
document is updated and distributed on a regular basis with school districts, agency
personnel, law enforcement and daycare providers in conjunction with the Weld County
Sheriff's Office and the Department of Human Services. It is currently being revised and
scheduled for distribution in Spring/Summer 2010.
In the 19th Judicial District, all cases of child abuse are reported to law enforcement or
the Department of Human Services depending upon the jurisdiction. It is the
responsibility of the agencies to respond to reports and to include other agencies as
necessary and in accordance with the Weld County Child Abuse Protocol. It is also the
responsibility of the responding agency to coordinate the time and place of the interview
with the family or non-offending parent. Once a report of abuse is made, the responding
agency contacts the other agency and the family along with the CAC to set up an
interview.The CAC contacts the District Attorney's Office to let them know of the
scheduled interview and see if they can attend. Prior to the interview both responding
agencies share information about the incident report. All investigating agencies meet at
the CAC prior to the interview to provide case information and updates. After the
interview, the MDT will meet again to discuss the interview and prepare to meet with the
child's parents/guardians. Depending on the disclosure by the child, the CAC may be
requested to schedule a medical exam for the child.
The AKP Case Review Team's mission is to enhance child abuse investigations by
gathering, reviewing, and exchanging information in a collaborative effort to promote
the effectiveness of an interdisciplinary team comprised of existing community agencies
involved in the investigation and prosecution of crimes against children.Team members
meet prior to the interview to discuss the plan for the interview and the investigation.
Also, on a monthly basis all MDT members meet to discuss issues in cases at the CAC for
Case Review.These meetings are held on the 4th Tuesday of the month at noon. All MDT
members are invited to participate in Case Review regardless of if they have a case up for
review or not.
The CAC has an open door policy for law enforcement, caseworkers, medical providers
and the DA to provide immediate feedback on services provided. Quarterly, the "Core
Team" meets (made up of an investigator of the Weld County Sheriff's Office, a
detective with the Greeley Police Department, a detective with the Evans Police
Department, a Caseworker from the Department of Human Services, a medical provider,
4
a District Attorney, and a mental health provider)to discuss issues arising with services,
investigations, policies etc. Finally, at the end of each year, anonymous program surveys
go out to all MDT members with questions about present services and asking for input
on future or additional services they would like to see provided. Surveys are sent out in
January of each year.
A Kid's Place through the CAC provides information each year for team members
regarding pertinent local, state and national training, including NCA net video training.
The staff also organizes a local training for MDT members. Through our affiliation with
the Colorado Children's Alliance and the Western Regional CAC, we are aware of other
state trainings. Our agency also houses a CASA Program and opens CASA volunteer
training to all MDT members to enhance their skills. Training is also provided at Case
Review regarding each team member's response to investigations and their role as part
of the MDT. Additional trainings are provided at Case review when the team identifies a
need. Investigators and caseworkers also routinely attend training provided by their
respective departments.
V. FORENSIC INTERVIEW PROTOCOLS
Training Requirements for Forensic Interviewers: A Kid's Place has a quarter-time
trained forensic interviewer on staff. Additionally, any law enforcement official or
Department of Human Service's caseworker may conduct the interview provided
they can demonstrate they have the appropriate training. All forensic interviewers
must provide A Kid's Place with documentation of participation in a competency-
based child abuse forensic interview training that includes child development or a 40
hour nationally recognized forensic interview training that includes child
development including but not limited to CornerHouse Child Sexual Abuse Forensic
Interview Training, First WitnessTM Forensic Interview Training, ChildFirstTM: Forensic
Interviewing and Preparing for Court, Finding Words" Forensic Interview Training,
NICHD, and National Children's Advocacy Center Forensic Interview training.
A copy of the Certificate of Completion from any above referenced training will serve
as documentation and will be kept on file at A Kid's Place. No one will be able to
conduct a forensic interview at A Kid's Place without documentation on file.
The CAC Administrator will provide information on forensic interview training
opportunities to all MDT members via e-mail or phone contact. They will assist any
MDT member with clarification of questions regarding the said training, registration,
etc. as needed. This information will initially be provided by The National Children's
Alliance, the training providers themselves or a CAC who is sponsoring training.The
executive director will communicate with other state directors to insure that
information regarding state trainings is provided to all MDT members.
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Interview protocols: Law Enforcement is responsible for its own investigations. The
CAC strongly encourages human services and law enforcement workers to meet prior
to an interview to determine a plan of action. This plan of action includes, but is not
limited to, who should conduct the interview, who should take notes, whether a
parent or other guardian's presence would be helpful or a deterrent, the
environment in which the interview is conducted, and the time and location. Prior to
the interview, the forensic interviewer and the referring party will meet to discuss
the allegations.They will provide the interviewer with details and information
needed to objectively interview children in order to substantiate truthful allegations
and rule out false claims.Therefore, the referring agency will arrive before the
scheduled interview time. After the interview, the parties will discuss what
information will be presented to the parents/caregivers and what services are
needed.The referring agency and the forensic interviewer will meet with the non-
offending caretaker after the interview to discuss the results of the interview, what
the family can expect to happen next and to answer questions.
Forensic interviews at AKP are conducted by the part time on staff forensic
interviewer, law enforcement or social services personnel who have received training
specific to the best accepted practice regarding forensic interviewing of children and
have their documentation on file at A Kid's Place. Staff also provides feedback in
conjunction with the District Attorney at a Case Review meeting or privately to
interviewers when concerns arise. Training includes components of cognitive skills
assessment, rapport building, truth and lie understanding, child development,
anatomical drawings, the use of anatomical dolls, questions utilizing non-leading
techniques and how to handle a reluctant disclosure. Interviews are video-recorded
by the staff of the CAC, in order to avoid the child being interviewed multiple times.
Various interview aids will be provided by the CAC including culturally appropriate
anatomical drawings and dolls,Truth and Lie worksheet, an easel with a flip chart,
markers, crayons, pens and drawing paper and other manipulates such as play
dough.
Team investigations are scheduled between team members to allow them all to be
present at the interview so each can complete their responsibilities. Team members
communicate and share information during the investigation before and beyond the
forensic interview.The CAC staff will inform the District Attorney's Office of any
interviews as soon they are scheduled at the CAC. They will inform the DA's Office of
any changes in the time or date of the interview. Any interview involving an adult
offender will be forwarded to the DA handling the filings for adults. Any interview
involving a juvenile offender will be forwarded to the DA handling the filing on
juvenile cases. All interviews are video and audio recorded to provide an opportunity
for review at a later date. DVD's are shared between LE, caseworkers and the DA's
Office as the need arises. Prior to a medical exam, LE fills out a medical form
detailing the information they received during the interview. This medical form along
6
with the child's name, age, and additional information is then faxed to the medical
examiner prior to the medical exam.
All 17 LE agencies in Weld County have signed a Cooperating Team Agreement with A
Kid's Place. Interviews are routinely conducted at the CAC and strongly encouraged
by the interdisciplinary team to be conducted there. LE uses the facility to interview
all small children but periodically depending on distance and age of the child, older
children may be interviewed in other places. It is the expectation of The DA's Office
that all interviews be done at the CAC.
Referral Criteria: A referral for A Kid's Place may be received from the District
Attorney's office, any one of the 17 law enforcement jurisdictions located in Weld
County, Colorado or the Weld County Department of Human Services. Courtesy
interviews may be requested from any law enforcement jurisdiction.
The referrals will meet the following criteria:
• Children ages three (3) through seventeen (17) as deemed appropriate.
Decisions to interview children under the age of three will be determined on a
case by case basis. Children under the age of three usually do not possess the
cognitive and linguistic skills to participate in the interview.
• The allegation involves sexual assault or abuse.
• The allegation involves severe physical abuse. Allegations of minor sexual
abuse will be determined on a case by case basis.
• The allegation involves offending children under the age of ten (io).
• Referrals involving sexualized behaviors of children twelve (12) and under will
be determined on a case by case basis.
• Referrals where a child(ren) may have witnessed a crime.
Referral Procedures: A Kid's Place staff receives the initial referral for the interview.
The intake form is completed to insure the referral meets the CAC criteria and
adequate information is obtained to set the interview. The referring agency will
provide basic details such as the child's name and DOB, the reason for the interview,
the parents' name and DOB,the person bringing the child to the interview, if a
translator is needed, any special needs the child(ren) may have, the alleged
offender's name and DOB, the alleged offender's relationship to the child(ren) and
the LE case number if applicable.
• All reports of suspected child abuse and neglect shall be reported to DHS
and/or LE as dictated by the Weld County Child Abuse Protocol.
• Representatives from any LE agency or DHS may contact the CAC to request a
forensic interview.
• A CAC staff person will complete the intake form.
• A date and time of availability will be provided to the referring agency and the
referring agency will inform the parent/guardian of the child of the scheduled
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appointment.As A Kid's Place is a contract agency and has no legal authority
to request that caretakers are cooperative, it is important that the forensic
interview is arranged by the referring agency.
• The CAC staff will input the interview time and date on the master calendar
and add the intake form to the CAC Interview binder.
• CAC staff will contact the District Attorney's office to notify them of the time
and date of the interview. They will provide the DA with the child's name and
DOB,the alleged offender's name and DOB, their relation to the child, the
name of the LE and the investigator handling the case and LE's case number.
• The referring agency will contact the CAC with any changes or cancellations of
scheduled interviews.
Best practices for interviewing child victims and witnesses of crime, stress the need
to utilize Child Advocacy Centers.The American Bar Association at its 2009 Midyear
Meeting passed a resolution Addressing the Needs of Child Victims that "urges federal,
state, tribal, local and territorial governments to ensure that child victims of criminal
conduct have prompt access to legal advice and counsel and to specialized services
and protections such as those provided by child advocacy centers and accredited by
the National Children's Alliance."
A Kid's Place CAC provides a child friendly environment designed to meet the needs
of children who are alleged to have been abused or witnessed a crime.The CAC
provides
• support and protection for the child and the non-offending family members
• a trained forensic interviewer
• a formal, comprehensive multidisciplinary response to child abuse which is
designed to meet the needs of the child victim.
• A neutral facility
• family advocacy which provides non-offending family members with needed
resources such as victim's compensation, counseling referrals, and
information on sexual abuse and legal proceedings.
• coordination and tracking of investigative, prosecutorial and treatment
efforts.
Communication with MDT members and the Use of Interpreters: Sharing of
information among team members is done in several different ways: before an
interview starts team members who are involved with the case will talk in the CAC
observation room to share information. During the interview they will talk, if
necessary,to insure all questions are answered and all information is gathered. The
interviewer will either take a break from the interview to talk with the MDT or wear
an ear bud that allows the MDT to communicate with them. Other team members
may observe the interview through closed circuit television. The lead interviewer
8
must have training specific to the best accepted practice regarding forensic
interviewing of children and have their documentation on file at A Kid's Place. If an
interpreter is needed for the actual forensic interview, the lead investigator will make
arrangements to have either a forensic interviewer conduct the interview that is
fluent in that language or, with the help of the CAC staff, hire a court certified
interpreter who is fluent in the child's language. If a parent is in need of an
interpreter, the CAC staff will be responsible for insuring a translator is available to
conduct the family advocacy. One time a month the Multi-disciplinary team gets
together for Case Review. This involves law enforcement, medical personnel, District
Attorneys,A Kid's Place staff personnel, mental health, and caseworkers from the
Department of Human Services. Cases are discussed among the group.
We strongly encourage all law enforcement conducting interviews to wear regular
street clothes. This helps lessen the anxiety of the child during the interview process.
Law enforcement will not be allowed to wear their weapon during an interview. AKP
guides all team members during the interview process to include selection of an
appropriate trained interviewer; team members have a private meeting room to
share information at the CAC; and monthly case reviews include collaborative case
planning.
Training: The CAC staff will notify all MDT members of training opportunities
including but not limited to:forensic interviewing of children, advanced forensic
interviewing, child fatalities, and cultural diversity. The CAC Administrator will provide
information on training opportunities, related articles, DVD's, research, etc..to all
MDT members via e-mail or phone contact. They will assist any MDT member with
clarification of questions regarding the said training, registration, etc.. as needed.
This information will initially be provided by The National Children's Alliance, the
training providers themselves or a CAC who is sponsoring a training. The executive
director will communicate with other state directors to insure that information
regarding state trainings is provided to all MDT members. MDT members will have
the opportunity to join the CALiO Library through NCAC. All professionals who
interview at A Kid's Place will be subject to yearly peer review and must have
ongoing education in the field of child maltreatment and/or forensic interviewing
consisting of a minimum of 3 hours per every 2 years of CEU/CME credits. All
interviewers must provide AKP with documentation or their CEU/CME every two
years.
Peer Review: The CAC manager will be in charge of setting up peer review for any
one who interviews at A Kid's Place. It will take place twice a year. Interviewers can
schedule which time of year they would like to be reviewed. Peer review can also be
arranged through the National Children's Alliance.
Peer review will be done on closed or adjudicated cases only. Each interviewer will
pick two of their own interviews that they want reviewed. The evaluation addresses
9
the strengths of the interviewer, recognizes challenges faced during the interview
process, and areas to strengthen. Feedback is specific and clear, but not critical. All
feedback will be done verbally. Evaluation will be done by forensic interviewers who
do not interview at A Kid's Place but do interview at CACs in Colorado. They will take
into consideration the following elements:
• Rapport Building
• Developmental Screening
• Introduction of Guidelines
• Facilitation of Disclosure
• Clarification
• Use of Tools
• Closure
The interviewer will meet one on one with the evaluator to go over their
observations.The interviewer will have the opportunity to ask questions and get
clarification.
Recorded Forensic Interviews used in Peer Review:
• Are utilized for the purpose of professional consultation. Viewing of the DVDs
will be done only by qualified MDT members and Forensic Interviewers.
Information obtained during peer review will not be shared with anyone
outside the peer review process.
• Any forensic interview presented for peer review must be closed by the
Department of Human Services and the case must have already been
prosecuted or not accepted for prosecution by the District Attorney's Office.
• The forensic interviewer whose DVD is being reviewed must make
arrangements for the DVD to be transported to the review.The case file
should not be brought to peer review. Recorded DVDs of interviews are NOT
kept at the CAC.
Information Sharing: Information sharing among MDT members is essential to
insure that the needs of child victims and their families are met. The multidisciplinary
response to child victims of crime includes forensic interviews at an accredited CAC,
medical evaluations,therapeutic intervention, victim/support, prosecution, case
review and case tracking. Forensic interviews, victim/support, case review and case
tracking are headed by the CAC staff. Medical evaluations, therapeutic intervention
and prosecution are provided by other members of the MDT.This multidisciplinary
response is based on the Weld County Child Abuse Protocol and the MOU between
the parties and the CAC. Sharing of information among team members is done in
several different ways: before an interview starts team members who are involved
with the case will talk in the CAC observation room to share information. During the
interview they will talk, if necessary, to insure all questions are answered and all
10
information is gathered.The interviewer will either take a break from the interview
to talk with the MDT or wear an ear bud that allows the MDT to communicate with
them. Other team members may observe the interview through closed circuit
television.The lead interviewer must have training specific to the best accepted
practice regarding forensic interviewing of children and have their documentation on
file at A Kid's Place. Team investigations are scheduled between team members to
allow them all to be present at the interview so each can complete their
responsibilities. Team members communicate and share information during the
investigation before and beyond the forensic interview. Prior to the interview, the
forensic interviewer and the referring party will meet to discuss the allegations. They
will provide the interviewer with details and information needed to objectively
interview children in order to substantiate truthful allegations and rule out false
claims.Therefore, the referring agency will arrive before the scheduled interview
time. After the interview, the parties will discuss what information will be presented
to the parents/care givers and what services are needed. The referring agency and
the forensic interviewer will meet with the non-offending caretaker after the
interview to discuss the results of the interview,what the family can expect to
happen next and to answer questions.
All interviews are video and audio recorded to provide an opportunity for review at a
later date. DVDs are shared between LE, caseworkers and the DA's Office as the
need arises. Prior to a medical exam, LE fills out a medical form detailing the
information they received during the interview. This medical form along with the
child's name, age, and additional information is then faxed to the medical examiner
prior to the medical exam.
One time a month the Multi-disciplinary team gets together for Case Review. This
involves law enforcement, medical personnel, District Attorney's Office, A Kid's Place
staff personnel, mental health, and caseworkers from the Department of Human
Services. Cases are discussed among the group. All MDT members attending case
review must sign a Confidentiality Agreement at the start of each Case Review
meeting.
VI. MEDICAL EVALUATION PROTOCOL
The child advocacy center feels that all children deserve the right to be medically
evaluated if there is suspicion of abuse or neglect. All children who are suspected of
being sexually abused or physically abused should have a comprehensive forensic
evaluation by a health care professional, experienced in the examination of young
children. Decisions with respect to scheduling a forensic evaluation are made
considering the emotional health, physical health, needs and comfort of the
individual child and at the discretion of the multidisciplinary team. A physical exam
will be arranged by A Kid's Place (AKP) on a case-by-case basis at the request of Law
Enforcement. An exam may also be requested and arranged by the Department of
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Human Services. Law enforcement will need to fill out the medical intake form with
as much detail as possible and provide the police report. This allows the medical
provider to perform a comprehensive exam based on the information provided in the
report and obtained from the child. A consent, and release for information form will
be signed by the parent of the child, either at AKP, or at the exam site. Consent can
be withdrawn at any time. The appropriate information will be faxed to the medical
examiner prior to the exam. Authorization for these examinations will generally be
approved by a parent, guardian, or pursuant to an order of the court.
According to Colorado State Statute, Law enforcement will be billed directly by each
provider and will pay for the cost of the medical exam. Evidentiary labs and follow-up
testing done for the child's health will be billed first to the victim's private insurance
or Medicaid and then to Victim's Compensation paperwork. This will allow the child
to receive medical care following the initial forensic exam for evidentiary purposes
without regard for the ability to pay. CAC staff are always available to help families
with Victim's Compensation paperwork and address any concerns they have.
For acute cases (up to 7 days depending upon the nature of the abuse) medical
examinations are performed at the emergency room at Medical Center of the
Rockies in neighboring Loveland, Colorado to allow for collection of forensic medical
evidence including but not limited to semen, saliva, blood, fibers, or material from
the crime scene. A patient's condition may dictate emergency medical treatment
without request of either law enforcement or the Department of Human Services.
The medical protocol for an examination of this nature should be consistent to
provide the highest quality of physical evidence, yet minimize further trauma to the
child. The purpose of the medical examination is to look for supporting evidence of
sexual abuse, screen for sexually transmitted diseases (STDs) and reassure the child
that his/her body is, or will be, "healthy.With the exception of procedures specific to
emergency care, general well child medical information such as blood pressure,
pulse, respiration, height, weight, infant head circumference, and completed growth
chart appropriate for the child's age and sex should be documented as appropriate.
Procedures includes referral of the child/family to an appropriate physician or agency.
Non acute exams are scheduled with Dottie Schulte, FNP-BC, currently providing this
off-site service for the Child Advocacy Center and the abused children in Weld County
in conjunction with her employer, North Colorado Family Medicine.
SUGGESTED CRITERIA FOR MEDICAL EXAMINATIONS:
1. Any injury to a child less than three years of age must be checked by a health
care professional. The only exception is where the injury is extremely minor
(i.e. a bruise that is isolated to one area without any swelling or a small
scratch) and the explanation fits the injury.
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2. Any injury to the head or face on any child must be checked by a health care
professional, especially where force is involved.
3. Any other injuries that are not minor in nature and may result in health
problems or complications if not checked out by an appropriate health care
professional should be checked. This includes, but is not limited to, fractures,
lots of bruising, welts, injuries, with swelling and/or tenderness.
4. Where there is an allegation of recent or chronic sexual abuse, the victim must
be checked by an appropriate health care professional who has expertise in
the area of sexual abuse. If the allegation involves sexual penetration or
sexual intrusion within the past seventy-two hours, an examination shall be
done immediately at the NCMC emergency department.
5. If a child appears ill (i.e. running a fever, open wounds, etc.) or complains of
any pain or tenderness, he/she may be referred to a health care professional
for a medical evaluation.
6. If a child does not appear"normal" physically, developmentally or
emotionally, the child must be referred to a health care professional for a
medical evaluation.
7. If there is any history of significant force used on the child especially in the
head, chest, and abdomen area, a consultation with a health care profession is
appropriate to determine is there are any internal injuries.
The requesting agency will coordinate with the medical professional performing the
examination in advance. Pre-examination coordination is essential to minimize the
number of interviews and trauma for the child, yet maximize the effectiveness and
efficiency of the examination. Examination coordination is one of the services
available to law enforcement through A Kid's Place (in cases of severe physical abuse,
and sexual abuse). Pre-examination coordination would typically include clarification
of the following issues:
• Treatment authorization;
• Medical records release documentation and to whom information may be
released;
• Background information defining the nature of what forensic and/or
corroborative evidence may be present;
• A brief medical history of the patient;
• What examination documentation will be produced, i.e. photographs, witness
etc.
Medical professionals are responsible for the following:
• Emergency medical treatment when deemed appropriate;
• Medical examinations and collection of forensic evidence;
• Medical examination performed by professionals with training in physical
examination, collection, and preservation of evidence from victims of sexual
abuse or other physical assault;
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• Completing sexual assault evidence collection kit when exam is being done at the
emergency room in certain sexual assault cases perpetrated up to 7 days after the
offense.
• Appropriate patient documentation;
• Court testimony;
• Medical direction and collaboration in the development and review of Weld
County Child Abuse Protocol Projects, when requested.
Exam Setup/Scheduling
A. A physical exam will be arranged by A Kid's Place on a case by case basis at
the request of Law Enforcement. An exam may also be requested and
arranged by the Department of Human Services.
B. A consent form will be signed by the parent of the child, either at AKP, or
at the exam site
C. The appropriate information will be faxed to the medical examiner prior to
the exam.
D. The child and family will be asked to arrive thirty minutes prior to the exam
time to fill out the appropriate forms.
History
A. An R.N., L.P.N., or Medical Assistant will bring the child/adolescent to an
examining room
B. The child/adolescent will be weighed and measured; a full set of vital signs
will be done, as well as a urinalysis. All adolescents will have urine HCG
performed.
C. The child and family will be greeted by the medical examiner.
D. The child/adolescent's family member will be interviewed for a complete
medical and social history
E. The child/adolescent will be interviewed alone, unless in distress, in which
case the child/adolescent will be interviewed in the presence of the family
member.
Exam
A. Culposcopic exam will be done for photomagnification. One roll of film
per case will be used.
B. The child/adolescent will be prepared for the exam by discussion of exam
positions,with demonstration using a doll, if necessary. The child will have
control of who is allowed to stay with him or her during the exam. The
child will be shown the culposcope, how it works, and will be allowed to
assist with the exam, if desired.
C. A complete head-to-toe physical exam will be performed. The last portion
of the physical exam will include the ano-genital exam.
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D. The child will first be examined in the supine frog-leg position with the
soles together, knees out and resting on the table. The child will also be
allowed to sit on the parent's lap if desired.
E. The external genitalia will be examined for signs of injury and infection.
The perineum will be examined for injuries, condylomata, herpetic lesions,
bruised, tears, and/or discharge. The hymen will be visualized using labial
separation and traction. The hymen will be examined for its shape,
symmetry of the lateral walls, posterior hymenal rim, abnormal vascularity,
lacerations, bruising, and discharge. If abnormalities are observed in any
prepubertal child, and in all adolescents, an ano-genital exam will be
performed in the knee-chest position. A speculum exam will not be done
on a prepubertal child.
F. Knee-Chest- Have the child get on all fours, with knees spread wider than
shoulders. Then have the child touch his/her chest to the exam table,
maintaining the knee placement with a swayed backbone. Use a drape
while adjusting the child's position. The knee-chest position is particularly
useful to visualize vaginal foreign bodies, and the posterior hymenal rim.
G. The rectum will be examined for trauma, including scars, bruising, tears,
anal tags, thick or thin skin in the midline anal gaping with stool in the
rectal vault flattened or thickened anal folds,fissures, venous congestion
of the perianal tissues, and immediate anal dilation.
Genitalia Findings
A. Prepubertal female-When documenting, refer to location of findings using
a "clock face" orientation, with the urethra at 12 o'clock and midline
posterior fourchette at 6 o'clock. Girls less than two, as well as older girls
after puberty may have redundant, estrogenized hymenal tissue with
bumps or tags. A non-estrogenized hymen is often crescent shaped with
little or no tissue between 10 and 2 o'clock, and may have bumps or tags.
Other normal findings include labial adhesions, ridges inside the vagina,
and bands between the labia minora and urethra. Clefts or defects of the
hymen may indicate injury, particularly when found in the posterior rim
between 5 and 7 o'clock. Absent hymen between 3 and 9 o'clock probably
indicates changes from previous injury. An enlarged hymenal opening
without signs of trauma should not be considered indicative of vaginal
penetration. The likelihood of significant physical findings increases if the
child provides a history of bleeding and when the examination is
conducted soon after the alleged abuse.
B. Pubertal female- Inspect the external genitalia for acute injury,
condylomata, herpes and lice. Perform, if possible, an internal speculum
and bi-manual examination and obtain routine cultures for STD's. Findings
suggestive of hymeneal injury can be easily confused with the normal
adolescent hymenal anatomy of redundant folds and notching. The edges
15
of the hymen may be explored by cotton swab. A virginal adolescent will
not have a speculum exam.
C. Male- Inspect the genitalia for infection or injury.
D. Findings/Rectum- Examine the rectum for trauma, including scars, bruising
or tears. Normal or non-specific findings include: anal tags, thick or
smooth skin in the midline, anal gaping with stool in the rectal vault,
flattened or thickened anal folds,fissures, and delayed venous congestion
of the perianal tissues. Immediate anal dilatation >15 millimeters without
stool in the rectal vault is suspicious. A deep peri-anal laceration extending
beyond the external anal sphincter is an indication of penetrating trauma.
Testing/Follow-up
A. Cultures and lab work will be obtained on a case by case basis
B. If done, cultures will be ordered, performed, labeled, and packaged by the
medical examiner
C. The child/adolescent will be treated for a sexually transmitted disease or
prophylaxed according to the AAP guidelines.
D. Blood studies will be performed on a case-by-case basis.
STD Testing: The Algorithm below will assist in deciding when to culture for STDs.
Cultures are only necessary for symptomatic males, or when the perpetrator is
documented to have an STD. In the presence of condyloma, rectal cultures for
gonorrhea and chlamydia and blood testing for syphilis Hepatitis C and HIV should be
considered. When obtaining N. gonorrhea (GC) and chlamydia cultures in pre-
pubertal girls, sample the mucosa just proximal or distal to the hymen with a
moistened Type I calgiswab. In pubertal females, sample the cervix. Presumptive
positive gonococcal cultures on Thayer-Martin media must be confirmed by at least 2
confirmatory tests (biochemical, enzyme substrate or serologic). Only GC and
Chlamydia cultures should be accepted as evidence of infection in prepubertal
children. Rapid tests, including DNA amplification are currently inadequate for legal
documentation.
Treatment: Prepubertal children do not require prophylactic antimicrobial treatment
for GC or chlamydia unless infection is thought to be likely. Gonorrhea vaginitis is
usually symptomatic in prepubertal girls. Adolescents should be offered STD
prophylaxis, and, if the assault was within 72 hours, pregnancy prophylaxis.
STD Prophylaxis: Trichomoniasis, bacterial vaginosis, chlamydia and gonorrhea are
the most frequently diagnosed infections among adolescents who have been
sexually assaulted. Hepatitis B infection can be prevented by post-exposure
administration of Hepatitis B vaccine, and should be considered for adolescents who
have not received the vaccine. Prophylaxis guidelines are published periodically by
the Center for Disease Control (CDC) in the Morbidity and Mortality Weekly Report.
16
current updates appear on their website. The CDC recommends a follow-up
examination for adolescents two weeks after the assault.
Treatment includes:
Cefixime 400mg PO x 1 or Ceftriaxone 125mg IM x
or
Spectinomycin 4o mg/kg IM xi (max 2g)for PCN allergic patients
and
Azithromycin ig PO x 1, or Doxycycline loo mg PO Bid x 7 days (if>g y/o)
and
Metronidazole 2 grams PO x 1
Pregnancy Prophylaxis: Prophylaxis against pregnancy should be offered in all cases
of sexual assault which may result in pregnancy. Prophylaxis consists of two Ovral
tablets within 72 hours of the assault,followed by two additional tablets 12 hours
after the first. Consider Benadryl 25-50 mg ''/: hour prior to administering Ovral to
prevent nausea.
NOTIFICATION OF EXAM RESULTS
A. The detective on the case, and human services as involved, will be notified
of
the exam results immediately after the exam by the medical examiner by
phone.
B. Any pictures taken during the exam will be taken digitally.
C. The digital evidence will be picked up by law enforcement and processed
by law enforcement as needed.
D. The digital evidence will be numbered and logged into the photo evidence
log.
E. Digital evidence not yet delivered to Law Enforcement, will be kept at the
exam site under lock and key. The medical examiner is the only person to
have a key to the said locked files.
F. The medical report will be completed, and forwarded to Law Enforcement,
within 2 weeks of the exam date, unless the medical examiner and Law
Enforcement discuss a mutually agreed upon time frame.
G. Upon completion, the medical report will be faxed to Law Enforcement
and human services when involved.
H. The medical professional will log all appropriate information into their
Sexual Abuse Exam Log.
The medical provider is invited to all case review meetings. If a case is set for review
that involves a sexual assault exam, then that provider is expected to attend case
review either in person or by phone. Results will not be shared with suspected
perpetrators who are also parents or guardians of the child. Even when parents or
guardians are not suspected perpetrators, only information necessary to the child's
17
safety or medical needs can be released when the examination was part of an on-
going criminal investigation. This is necessary to avoid the potential of compromising
the criminal investigation. If further treatment or hospitalization is needed, the
medical professional is able to inform the child(if applicable) and the parents or
guardian of the need and the medical reason for this recommendation. A Kid's Place
does not retain copies of the written report or other diagnostic information.
Reporting Suspected Abuse: A patient's condition may dictate emergency medical
treatment with or without the request of either law enforcement or the Department
of Human Services. If further treatment or hospitalization is needed, the medical
professional is able to inform the child (if applicable) and the parents or guardian of
the need and the medical reason for this recommendation. The State of Colorado
requires that all medical personnel report any instances of abuse. A report can be
made to the Department of Human Services at 352-1551 ext. 6211.
VII. MENTAL HEALTH PROTOCOL
A Kid's Place acts as a referral source for families needing mental health treatment. A
Kid's Place keeps an updated mental health provider list. We have a county wide list
as well as a separate list for providers in South Weld County. We have a process in
place that only allows qualified mental health professionals to be on our referral list
that includes they have met the required set of criteria according to National
Children's Alliance standards: Masters prepared in a related mental health field;
Student intern in an accredited graduate program; Licensed/certified or supervised
by a licensed mental health professional; a training plan for 4o contact hours of
specialized; trauma focused mental health training; clinical consultation, clinical
supervision; peer supervision, and/or mentoring within the first 6 months of
association (or demonstrated relevant experience prior to association.
Mental health services for non-offending family members and/or caregivers are
routinely available on-site via linkage agreements with other appropriate agencies or
providers. A Kid's Place does not have mental health services on site.
Parents/guardians may also seek and obtain mental health treatment for their
charges and themselves from providers with whom the CAC does not have linkage
agreements. All families seen at the CAC are referred to qualified counseling
professionals in the county and are provided a list with names, addresses and phone
numbers of the counseling services as well as contact information for the counselor,
and a list of what forms of payment each counselor takes i.e., Medicaid, Victims
Compensation, sliding scale or private insurance. All providers on this list have
special training working with child abuse victims and their families, as cited above,
according to NCA Standards.
Additionally, the family can be provided referrals to other needed services that would
benefit the family during this traumatic time.This includes but is not limited to
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community agencies such as the Weld Food Bank, clothing banks, United Way 211,
and parenting classes among others. The agency also stocks a small donation room
on the premises and is able to provide the family with clothing, diapers, toiletries,
blankets and other small household items if needed. None of these extra items are
made available to any family member until after the conclusion of the entire
interview.
Victim's Compensation: Staff informs the family/guardian of the Victim's
Compensation Program and assists with filling out paperwork and getting it to the
District Attorney's Office if needed. In Weld County, the Victim's Compensation
Board has placed a high priority on covering the cost of counseling for child abuse
victims and their families.
Access to Mental Health: Our Mental Health Provider List includes detailed
information about the types of payment each provider accepts.The variety of
providers ensures the ability of being able to meet a variety of client needs.They
include Private insurance, Medicaid, sliding fee scales and Victim's Compensation
Funds. Our local Mental Health agency, North Range Behavioral Health is able to
offer rates at as low as $5 per session. We also provide information about Child Safe,
Inc. located in neighboring Larimer County with services also provided in Weld
County. This agency does not refuse services to any clients. Families who are
involved with the Department of Human Services, may be eligible for mental health
services through the Department.
Mental health services for child victims, non-offending family members and/or
caregivers are available via linkage agreements with appropriate agencies or
providers. These services include, but are not limited to individual therapy for
primary and secondary victims and support groups for adults, non-offending family
members and caregivers. Parents/guardians may also seek and obtain mental health
treatment for their charges and themselves from providers with whom the CAC does
not link agreements. All families seen at the CAC are referred to counseling
professionals in the county. If a family resides in a county other then Weld,the CAC
manager will contact the CAC in that county for a list of their mental health providers.
Our mental health protocols ensure that all clients will be able to access appropriate
mental health evaluation and treatment. It also identifies how those services can be
accessed.
Mental Health and Case Review: Our Case Review Protocol includes attendance of a
mental health therapist.At this time, our mental health professional is a therapist on
the Child and Family Team at North Range Behavioral Health , a local county mental
health center and substance abuse treatment provider.
Requirements of the mental health professional serving as a member of the MDT
include general consultation regarding child sexual abuse and trauma. This provider
19
does not normally have knowledge specific to the case being reviewed but helps to
identify particular mental health concerns relevant to that case.The provider can also
assist with case tracking, case reviewing and coordination of services to ensure a
child and his/her family, when appropriate, is referred to and obtains the mental
health services needed. All members of the MDT sign a Confidentiality Agreement at
the beginning of every Case Review.
Law enforcement or the Department of Human Services may request assistance
when interviewing a child victim or witness in a child abuse or neglect investigation.
Mental health professionals will make every effort to provide assistance. Providing
such assistance may require a mental health professional to go to A Kid's Place to be
part of the interview team for consultation purposes only.
Confidentiality and Mental Health: Confidentiality relates to how private
information is handled once the information has been divulged. Confidentiality
requires information be administered in such a manner to ensure no harm will befall
the client as a result of having disclosed information to the mental health
professional.Typically, confidentiality assures that client information is not used for
personal gain or curiosity and is shared with other professionals involved in the care
of the client only after obtaining a proper authorization to release information.
When dealing with persons under the age of 18 years, mental health professionals
must consider the ethical concept of "best interests of the child."This ethical
concept requires the MDT mental health professional to consider what actions, in
his/her professional judgment, would best meet the needs and interests of the child
in any given situation. Typically, confidentiality assures that client information is not
used for personal gain or curiosity. The mental health therapist on our MDT serves
primarily in the role of a consultant, educating other members of the team in mental
health matters, provided that the client's rights to confidentiality and privacy are not
compromised. It is up to the therapist on the MDT to obtain a separate release if they
are exchanging information related to a specific child victim or family member.All
confidentiality laws, including HIPPA regulations extend to mental health records.
Therefore, all mental health providers are bound to follow these laws. AKP does not
provide direct mental health treatment, therefore no mental health records are kept
on-site.
VIII. VICTIM ADVOCACY PROTOCOLS
Providing a warm, comfortable, and private environment for the necessary
interviews of abused children is only the first step in what may be a long, confusing,
and traumatic experience for a child. In addition to being interviewed, a child may
have to deal with a confused or distraught family, and may have to face the unknown
of testifying in court. In the life of a child, the response of the "system" may seem
overwhelming.Therefore, the process of responding to a child and his/her family
20
during the investigation of child abuse is as important as the environment in which
the interview takes place.
The CAC provides immediate crisis support for families, parent resource information
about the system, as well as, dealing with abuse both within and from outside the
family, community resource information, and education for child victims and families
concerning the court process. This coordination of services and provision of
resources and emotional support results in victims and families who are more able
and willing to cooperate with a criminal justice system which may seem confusing
and add to a families' emotional turmoil.
Families seen at A Kid's Place will be provided with the following information during
their visit:
• A Kid's Place Parent Handbook
• Crime Victim's Compensation Application
• Crime Victim's Rights Information
• Counseling Referrals
• Age and Gender Appropriate Information about Abuse
• Other Community Services as Needed
When non-offending parents first visit the CAC,they are often in crisis and may be
using all their coping skills in order to deal with their child's disclosure and the
resulting investigation. Non-offending parents in these crisis situations often
experience feelings of helplessness and confusion and fear for what the future may
hold for their child and family as well as the unknown of the continuing system
process. A sensitive and coordinated response is needed so families and children can
begin to deal with the abuse and ultimately heal from their emotional wounds.
In order to respond and provide such support for parents, CAC staff are available to
answer questions parents may have about the system of investigation and
prosecution, what types of behaviors they may expect of their child, as well as what
resources are available within the community. CAC staff may assist with many
referrals including; domestic violence, parent education groups,therapists, etc.
The parent/guardian will be asked to participate in the A Kid's Place follow-up survey.
This survey will be mailed to families approximately one week after their initial visit
with a self addressed stamped envelope for the response.
Families that have given permission for the CAC staff to re-contact them (via the
release form)will be called approximately one month following their initial visit to
determine how the family is doing, what additional services they would like to see
provided and any questions or concern that they may have.
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IX. CASE REVIEW PROTOCOLS
The AKP Case Review Team's mission is to enhance child abuse investigations by
gathering, reviewing, and exchanging information in a collaborative effort to
promote the effectiveness of an interdisciplinary team comprised of existing
community agencies involved in the investigation and prosecution of crimes against
children.
Case Review meetings are held the fourth Tuesday of each month (holidays
excepted)from 12:00 —1:30 p.m. at the Greeley Police Department. Notification of
Case Review is given by way of e-mail or a personal phone call from the CAC
manager. Emergency Case Reviews may be called by any team member at any time.
The team member requesting the emergency case review must contact the staff at
AKP who would in-turn call or e-mail the rest of the team members to inform them of
the meeting time and place.
Representatives routinely participating in case review include, at a
Minimum:
• law enforcement
• child protective services
• prosecution
• medical
• mental health
• victim advocacy and
• Children's Advocacy Center Staff
The cases to be reviewed are chosen by the Deputy District Attorney and the MDT.
They are asked to provide cases a week prior to case review so they can be included
in the agenda. The agenda includes those members of the MDT that were involved in
the case to insure that they will be present at that particular Case Review. All
members of the MDT are invited to Case Review as the combined wisdom and
professional knowledge of law enforcement, child protective services, prosecution,
medical, mental health and victim advocacy results in a more comprehensive review
of case issues and provides for the most effective response. All persons attending a
Case Review meeting must sign the Confidentiality Agreement each time they attend.
Participation in Case Review meetings provides all parties with valuable information
and helps to set case goals, which ultimately benefit the children involved. The goal
of the CAC is to help facilitate communication between all professionals involved in a
child's case.
Expectations of participating team members include respect for one's professional
role, active listening and in some cases, agreeing to disagree. The meeting is
facilitated by the CAC Coordinator with the assistance of the Deputy District
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Attorney.The agenda includes introductions, announcements, case law updates (as
they are available), follow-up from previous meetings, helpful hints, new cases,
presentations, medical exam updates, training opportunities when available, and
opportunities to address issues that arise between agencies during the cooperative
investigation. Recommendations are made by the medical examiner, mental health
professional and the Department of Human Services about what services need to be
implemented for the child and family.
At least one team member must be present to present the case. That team member
would communicate to the absent team member/s recommendations and
implementation. If no team member attends, it will be postponed until the next Case
Review. If a case must be reviewed, an emergency Case Review session can be called.
Participation in Case Review offers all parties the opportunity to ask questions of
DHS, law enforcement, prosecution, mental health professionals and medical
personnel, thus helping all parties to understand the complexity of child abuse and
the numerous systems that must collaborate to help victims and their families. Each
case is thoroughly reviewed by a representative from each agency so that all parties
understand what actions are needed. Minutes are not taken during case review due
to the confidentiality of the cases.
If an MDT member cannot attend Case Review but their participation is desired,A
Kid's Place staff has the ability to set up conferencing equipment that will allow up to
three individuals to attend via phone. If a party is absent during the review of their
case it is the responsibility of the facilitator to insure that any recommendations by
the MDT is passed along to that party.
Specific Case Review Goals and Objectives are:
GOAL I. Basic Case Information Gathering and Sharing
Objectives: 1. Review the child interview outcome
2. Discuss Progress/Status of Investigation
3. Determine Medical Assessment Needs
4. Review Medical Assessment Outcomes
GOAL II. Brainstorm and Develop Coordinated Strategies and Problem Solving
Objectives: i. Discuss Protection Issues, Concerns
2. Discuss Treatment Issues, Referrals for Therapeutic Services
3. Review Prosecution Issues, Concerns, Options
GOAL III. Case Tracking, Sharing Final Disposition Information
Objectives: 1. Insure Tracking Status of Case Throughout Process
GOAL IV. Team Building, Enhancing Team Process
Objectives: i. Establish Relationships
2. Establish Trust Among Team
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3. Provide Cross-Training Opportunities
4. Provide Orientation
5. Establish, Strengthen and Review the Case Review Process
Conflict Resolution and Policy Issues: Any conflicts among agencies regarding the
protocols and procedures shall be brought to the MDT Core Committee for
resolution. This key committee of the MDT was established to develop protocols,
policy and procedures as they relate to the MDT investigative members. Members of
this committee include representation from: District Attorney's Office, Law
Enforcement, Child Protective Services, mental health, LE Victim Advocates Program
and A Kid's Place staff.
The MDT has written goals and objectives, guiding principles and ground rules.These
are reviewed yearly and members are given copies. MDT members also agree on any
training or information they would like to receive during Case Review time.
During Case review:
The Forensic Interviewer will:
• Provide a synopsis of the interview
• Provide information on family dynamics
Law Enforcement will:
• Update the team on the status of the case including arrests, pretext calls, and
other interviews
• Discuss any obstacles impeding the investigation
• Discuss the results of any acute medical exam
The Department of Human Services will:
• Update the team on the status of their child abuse investigation
• Discuss any concerns regarding child safety or dynamics of the family(i.e.
substance abuse issues, homelessness, medical issues, mental health, past
abuse investigations)
• Discuss services that were offered to the family
The District Attorney will:
• Start Case Review but discussing any current court cases
• Update the team on case dispositions
• Provide case status updates
• Inform the team regarding any obstacles to the investigation or prosecution
• May request certain services from specific team members to enhance the
investigation or prosecution
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The Medical Provider will:
• Will discuss both negative and positive findings of medical exams
• Assist members with referrals for follow up if needed
• Provide the team with any information regarding concerns about or strengths
of the family(i.e. substance abuse issues, homelessness, medical issues,
mental health concerns)
A Kid's Place Staff will:
• Organize and facilitate Case Review
• Discuss any concerns regarding the family that arose out of the Family
Advocate piece
• Contact absent team members regarding any instructions the team provided
for them at Case Review
Case Review will also allow time for team members to discuss relevant issues
surrounding the investigation and prosecution of child abuse cases. Any team
member may request that a topic be discussed. The CAC manager will also be
responsible for providing team members with current information on topics including
but not limited to dynamics of child abuse and neglect,family dynamics,
developmental stages of children, cultural issues,forensic interviewing and Weld
County protocol.This information may be presented to team members through e-
mails, handouts at Case Review or actual trainings on a relevant topic.
X. CASE TRACKING PROTOCOLS
Program statistics or program information is tracked to record data and in order to
determine if the various programs are meeting the stated objectives. Services
offered by the CAC will be tracked as provided and reported on a monthly, quarterly,
and annual basis. CAC Coordinator will provide this information to the Executive
Director on the 5th day of each month for those reporting purposes.
Intake Forms: The client database contains information, which is input from intake
forms for the purpose of case tracking and easier counting of services provided. The
client database will be kept strictly confidential for use by CAC Program Coordinator
and CAC Staff.
Intake forms are filled out for every family when receiving their primary service.
Intake forms contain basic information on the children including age, birth date, race,
sex, parent name, birth date, address, and phone number, allegation, and names and
ages of any other individual present at the interview. Written records are for the
purposes of tracking statistics, receiving ongoing program funding support, and
grant reports.Therefore, information maintained in a child's record at the CAC is
minimal.
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Suspect information will also be tracked on the primary intake form and will include
name, age, birth date, race, sex, relationship to child, and any known prior child
abuse convictions.
Information on case outcome is also recorded and defined as follows:
• Founded—evidence exists which supports the allegation
• Unfounded—no evidence exits to support the allegation
• Unsubstantiated—some evidence exists, however, there is not enough
evidence to warrant prosecution
• Filed—the District Attorney's office determines there is sufficient evidence
to proceed with the prosecution of the case
• No file—the District Attorney's office determines there is not sufficient
evidence to prosecute the case
• Disposition
Database tracking contains the following information: Name, date of birth, age,
gender, nationality, language date seen at the CAC center, if a medical exam was
scheduled for each victim seen at the center. We also track the name, date of birth,
age, gender, nationality, language, address, for parent/guardian of the victim and
other non-offending family members and if parent packets were given to the parents
(refer to Victims Advocates Services). The CAC tracks the following information: law
enforcement agency, child protection worker, case #, offender information, type of
abuse, location of abuse, name of suspect, age, gender, nationality, relationship to
victim, discloser, and prosecution. Due to the fact that we are a unique agency and
have a CASA program along with the CAC we are able to have more information
about children who have a volunteer and have also been through the CAC.As part of
case review we are able to discuss with DHS the cases that have come though the
CAC and what the disposition was on these cases; if it was founded or unfounded and
what the outcome was. On a quarterly basis, the CAC Program Coordinator sends
over all the cases that have been through the CAC from each of the 17 law
enforcement agencies and the DA's office to get the disposition on the outcomes of
these cases if it was filed, closed, still under investigation, etc.
The CAC uses the web-based case tracking system called NCAtrak. Data is shared in a
variety of ways, through case intake, Case Review, Child Protection Team and reports
requested by the CAC of partner agencies.Team members have access to all tracking
information. All evidence or information gathered during an investigation at the CAC
is the property of the agency conducting the investigation/prosecution of the child's
case. However, as a part of the investigation/prosecution process, all records
maintained at the CAC are discoverable. Law enforcement can tell the number of
cases seen in their jurisdiction at the end of each month and the end of each year in
aggregate data.
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XI. CONFIDENTIALITY ISSUES
Staff of A Kid's Place are considered part of the multidisciplinary team and will be
privy to information concerning the cases that are investigated at the CAC. Staff
members may perform one or more roles during a child's visit.Those roles may
include forensic interviews, victim advocacy, emotional support, and providing the
family with educational information about victim's rights, victim's compensation,
sexual abuse, referrals to counseling services, and information about the system.
Any information pertinent to the case investigation and shared with CAC staff during
an investigation will be shared with the multidisciplinary team. Team members are
defined as individuals from A Kid's Place, the District Attorney's office, law
enforcement, Department of Human Services, mental health providers, the
appointed Guardian ad Litem and medical providers. All team members will keep the
confidentiality of the cases and know that information shared by CAC staff outside
the team and/or without a release of information is strictly forbidden and may be
grounds for dismissal.
The agency donor database contains community and contributor mailing information
only. No information pertaining to clients is kept in this database. This database is for
the sole use of providing information about CAC activities such as training
notification and for soliciting funds for the CAC.The information in this database will
not be shared with any other agency or individual. A Kid's Place does not sell its
mailing list or donor database.
Responding to Subpoenas/Court Orders: As part of a prosecution process, all
written records maintained at A Kid's Place are discoverable and may be subpoenaed
in a criminal proceeding. CAC records will not be released and CAC staff will not be a
witness without a subpoena or court order. When CAC records are subpoenaed, staff
will inform the Executive Director immediately. The CAC Program Coordinator will act
as the records keeper for the CAC intake forms. Staff will notify the District
Attorney's Office of the subpoena. Legal action to quash the subpoena may be taken
by this agency.
Video and DVD Recording: Recordings produced at the CAC during an investigation
are the property of law enforcement/district attorney's office or the Department
Human Services when law enforcement is not part of the interview process. All
videotapes produced by law enforcement will be placed into evidence at the
respective law enforcement department. A Kid's Place does not make or retain
copies of the videotaped interview.
Medical Files: Medical records on children who are examined by a medical provider
contracted with A Kid's Place are kept in a locked file at the office of the medical
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provider.An oral report will be given to law enforcement and the Department of
Human Services (when involved) immediately following the medical exam. Within 2
weeks of the exam a complete written report along will be sent to law enforcement.
A Kid's Place does not retain copies of the written reports or other diagnostic
information. A Kid's Place does maintain a copy of the medical release of information
and referral form on file.
Computer Database: Computer records are maintained when each child receives
his/her primary service at the CAC. Computer records contain statistical information
taken from the Intake Form and Program Tracking logs. CAC staff will not keep
additional and separate case notes on CAC computers.
XII. Scholarship Policy
Based upon the monies available for training during the year,A Kid's Place may make
scholarships available for law enforcement and caseworkers to attend national and
local training. A Kid's Place will select the training sessions based upon the evaluation
and responses to the annual training survey. A Request for Proposals (RFP)will be
sent to each investigator/caseworker along with an application for the scholarships
and training sessions. Recipients of the scholarships will be determined using the
following criteria:
• Requesting agency is a member of the Multi-Disciplinary Team
• Investigator/caseworker regularly attends and participates in monthly case
review.
• Investigator/caseworker is an active participant of the Multi-Disciplinary
Team.
• Investigator/caseworker has participated in training sponsored by A Kid's
Place within the last year.
• Investigator/caseworker has been investigating crimes against children for
at least i year at the time of the request and plans to remain in their position
for a least i year following the training class.
• Priority will be given to a need within the community and agency applying.
• Applications from rural law enforcement agencies are strongly encouraged.
XIII. Volunteer Screening Procedures
All volunteers and student interns who work at A Kid's Place through the CAC are
required to undergo a screening process that includes:
• An interview
• A reference check
• Colorado Bureau of Investigations check through Intermountain
Backgrounds, Inc.
• Confidentiality Agreement
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A Kid's Place provides liability insurance which covers the actions of staff and
volunteers. Volunteers at the CAC are supervised by the Program Coordinator; who
also provides Volunteer Orientation training depending upon the volunteer
responsibilities.
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