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The Children’sAdvocacyCenter

Of Gregg and HarrisonCounties

Protocol

The Mission of the Children's Advocacy Center of Gregg and Harrison Counties (CACGHC) is to lessen the emotional trauma to children by coordinating multidisciplinary investigation, assessment, prosecution and treatment of child abuse.

GOALS AND OBJECTIVES

  • To maintain a formal comprehensive, multidisciplinary response designed to meet the needs of child abuse victims and their families.
  • To operate in a neutral facility where investigative interviews will be conducted and services for abused children and their families can be provided.
  • To lessen or prevent trauma to the child associated with multiple interviews with different community professionals.
  • To provide victims and families with appropriate services and/or referrals.
  • To maintain open communication and case coordination among community professionals and agencies involved in child protection efforts.
  • To coordinate and track investigative, prosecutorial, and treatment efforts.
  • To obtain information useful for criminal and civil proceedings.
  • To enhance the professional skills necessary to effectively respond to child abuse cases through on-going training and professional development.
  • To increase community awareness and community understanding of child abuse.

OPERATIONAL GUIDELINES

The Children's Advocacy Center of Gregg and HarrisonCountiesprimarily services victims of sexual or physical abuse under the age of 18 in Gregg and Harrison counties. The Center also provides interviewing services for other counties. Each member agency shall assume responsibility for referring cases in which they have involvement.

All agencies that sign the Children's Advocacy Center of Gregg and Harrison Counties Multi-Agency Agreement for Gregg and HarrisonCounties agree to abide by the protocols outlined in this agreement. Agencies from other counties who request the services of the Center must also agree to the following procedures described in this working protocol.

These guidelines are intended to offer professionals charged with investigating abuse with a framework for performing this important task. The guidelines reflect current knowledge and practices related to investigations and forensic interviews. These guidelines are not intended as an absolute standard to be adhered to in every case. There is no single correct way to interview a child or to investigate cases of suspected child abuse. Laws, court decisions, local practices, and the specifics of the case may dictate modifications. Investigators must remain flexible and continuously seek out new knowledge and research in applying these guidelines.

The Multidisciplinary Teams (MDT) are as follows:

GreggCounty

  • Gregg County District Attorney’s Office
  • Gregg County Sheriff’s Office
  • Longview Police Department
  • Kilgore Police Department
  • White Oak Police Department
  • Gladewater Police Department
  • Lakeport Police Department
  • Texas Department of Family and Protective Services – Child Protective Services
  • CACGHC

HarrisonCounty

  • Harrison County District Attorney’s Office
  • Harrison County Sheriff’s Office
  • Marshall Police Department
  • Hallsville City Marshal’s Office
  • Waskom Police Department
  • Texas Department of Family and Protective Services – Child Protective Services
  • CACGHC

AGENCY PARTNER AND AD-HOC MDT MEMBER ROLES

Child Protective Services

Cases handled by CPS are those identified by the Texas Family Code Chapter 261 and a child’s family or household are defined by Chapter 71 of the Texas Family Code:

  • A parent, guardian, managing or possessor conservator, or foster parent of the child
  • A person with whom the child’s parent cohabits
  • School personnel or volunteers at a child’s school

Role of Children’s Protective Services within the Multi-disciplinary Team:

  1. CPS caseworkers will utilize CACGHC resources for cases of sexual abuse and severe physical abuse.
  1. CPS caseworker and law enforcement will strive to conduct joint investigations of child abuse allegations.
  1. CPS will attend the appointments and observe the forensic interviews of cases referred.
  1. CPS caseworkers will participate in the case review team meetings, when their cases are scheduled for review or assign a representative to share case updates.
  1. Caseworkers will advise the CACGHC on case dispositionsat the MDT.
  1. If the CPS caseworker is unable to attend the MDT meeting they will assign a representative to attend and update the team.

Law Enforcement

Law Enforcement agencies are responsible for conducting criminal investigations of child abuse cases in which a crime may have occurred as defined by the Texas Family Code and the Texas Penal Code.

Role of Law Enforcement in the Multi-disciplinary Team:

  1. Law Enforcement (LE) will utilize the resources of the CACGHC for severe physical abuse, sexual abuse cases, and witnesses as defined in the Case Criteria section.
  1. LE and CPS caseworkers will strive to conduct joint investigations of child abuse allegations.
  1. LE will attend the appointments and observe the forensic interviews of cases referred.
  1. LE will participate in the case review team meetings, when their cases are scheduled for review or assign a representative to share case updates.
  1. LE advises the CACGHC of case dispositions at the MDT.
  1. If law enforcement is unable to attend the MDT meeting they will assign a representative to attend and update the team.

District Attorney’s Office

The District Attorney’s Office, where possible, will prosecute criminal cases of physical abuse, sexual abuse and neglect of a child where the alleged defendant is either juvenile or adult.

Role of Prosecutors in the Multi-disciplinary Team:

  1. The District Attorney’s Office will provide the CACCHC dispositions of the cases that are prosecuted or presented before the grand juryat the MDT.
  1. If the District Attorney is unable to attend the MDT meeting, they will assign an agency representative to attend and update the team.
  1. The District Attorney’s Office will communicate to investigating agencies what information is needed to ready a case for prosecution.

Children's AdvocacyCenter of Gregg and HarrisonCounties(CACGHC)

The Children's Advocacy Center of East Texas (CACGHC) is responsible for providing an avenue to lessen the emotional trauma to children by coordinating multidisciplinary investigation, assessment, prosecution and treatment of child abuse.

The Role of CACGHC in Data and Information Sharing

  1. CACGHC will track client demographics such as age, sex, victimization, race and case outcomes.
  1. The CACGHC will maintain a case-tracking database to assist in the effective partnering and sharing of information.
  1. CACGHC will organize, host and schedule quarterly meetings with partnering agency heads and a representative of the CACET board

Role of CACGHC with in the Multi-disciplinary Team

  1. CACGHC will take the lead in gathering information needed from the Assistant District Attorney, Child Protective Services, and Law Enforcement to determine if a case should be scheduled for a MDT staffing.
  1. CACGHC will compile a list of cases to be reviewed at each MDT meeting
  1. CACGHC will compile a list of cases that do not need to be reviewed.
  1. CACGHC will schedule and send notifications to members of the cases to be staffed.
  1. CACGHC will participate in case review meetings.
  1. CACGHC will take notes and use the information gathered input into the data system as well as to reset cases, and gather additional information needed.

The Role of CACGHCin Advocacy

  1. CACGHC will screen families for available counseling benefits and make appropriate referrals.
  1. If the need for Crisis Counseling is present at the CACGHC on the day of the forensic interview the CACGHC staff will assist in the reduction of trauma and seek immediate intervention services.
  1. CACGHC will conduct a screening assessment for possible referral assistance to other social services agencies to meet needs not covered in counseling referrals.

The Role of CACGGHC regarding Forensic Interviews

  1. The CACGHC will provide space and equipment for forensic interviews.
  1. CACGHC will schedule the interview, use of equipment and a room for the forensic interviews.
  1. CACGHC staff will send interview confirmations to appropriate team memberswithin 12 hours of receipt of the request form.
  1. In those cases, where there is a guest interviewer the CACGHC will assist the interviewer in checking the DVR equipment prior to the taping to ensure it is in good working order.
  1. CACGHC will provide new, blank DVD’s that will be used to record the interview.
  1. During intake the CACGHC staff will meet and discuss family issues and needs with the parent/guardian.
  1. CACGHC will provide the child and family a tour the facility.
  1. CACGHC will have the family sign appropriate paper work.
  1. CACGHC will conduct a screening assessment for referral assistance to other social services agencies.
  1. CACGHC will conduct the interview unless other arrangements have been made.
  1. Upon completion of the interview CACGHC will facilitate the post interview meeting with CPS, and Law Enforcement.

Sexual Assault Nurse Examiner (SANE)

Sexual Assault Nurse Examiners will perform a forensic sexual assault examination of children, ages 0 – 17, which has been authorized by Law Enforcement and referred by the CACGHC. The purpose of the exam is to determine medical needs and collect forensic evidence.

Role of Sexual Assault Nurse Examiners in the Multi-disciplinary Team

  1. The Sexual Assault Nurse Examiner will attend when requested or assign a representative to share the information with the Team

Fiscal Responsibility: The law enforcement agency with jurisdiction in the investigation of the assault has full responsibility for the cost of SANE examinations. SANE exams are provided to the client without cost; therefore, the ability to pay is not a factor in determining need for exam.

Indications for SANE exam of Chronic Abuse Cases: (to be scheduled at the convenience of the child, non-offending caregiver, and SANE)

  • Assault occurred greater than 96 hours;
  • Outcry has been made of touch under the clothes and interview history warrants SANE exam;
  • Collaboration of team determines there are significant risk factors to warrant SANE exam

Contraindications for SANE exam: The following are guidelines to prevent further traumatization of the child. If there is any question whether the abuse has occurred, the exam should be performed.

Exams WILL NOT be preformed:

  • If there is absolutely no outcry made of touching under the clothes and no other history (Vaginal/Penile drainage, soreness or pain to genital area, positive results from physician or clinic of Sexually Transmitted Disease) to warrant a SANE exam;
  • In situations where consensual sex occurred between teens age 14 or older, and no partner was 3 years older than the other(s);
  • For the sole purpose of determining “virginity”.

Scheduling:

  • Chronic Assaults (those occurring 72-hours or more prior to report and without indications of trauma):

All chronic assault examinations of child patients should be scheduled through the CACGHC after authorization from law enforcement and conducted by a SANE at GoodShepherdMedicalCenter.

  • Acute Assaults (those occurring within 72 hours of the report or presenting with trauma):
  1. CASES PRESENTING INITIALLY TO LAW ENFORCEMENT/CHILD PROTECTIVE SERVICES: The agency receiving the initial report will refer the patient to the emergency room for immediate assessment.
  1. CASES PRESENTING INITALLY TO HOSPITAL EMERGENCY ROOM: Hospital emergency room personnel will follow their own policies and procedures for notification to law enforcement and Child Protective Services.
  1. CASES PRESENTING INTIALLY TO PHYSICIANS OFFICE: Doctors contacting the CACGHC will be encouraged to notify law enforcement and Child Protective Services and refer the patient to the emergency room for immediate assessment.

Coordination of services utilizing these three presentation protocols is intended to prevent multiple exams of a child. In addition the CACGHC staff routinely inquires about medical exams related to incident at intake.

Documentation and Evidence Collection: Each SANE will follow their hospital’s policies and procedures on the documentation and collection/preservation of evidence from an exam.

Physical Abuse Exams

Children, ages 0 – 17, that are presented to the CACGHC for physical abuse will be referred to the closest emergency room if other medical attention has not already been provided. The purpose is to ensure timely medical examination of children (anyone under 18 years of age) who present with a serious physical injury.

Children with non-emergent physical injuries or with a history of physical injury will be referred to their pediatrician.

Mental Health Counselors

Mental Health Counselors will provide individual, family or group counseling services when children and families are referred by the CACGHC either on or off-site of the CACGHC.

Role of the Mental Health Counselor in the Multi-Disciplinary Team

  1. The Mental Health Counselor will attend the MDT meeting or send a monthly summary to be shared by the facilitator of the MDT.

Mental Health Component Referral Protocol

Purpose:

To ensure children (anyone under 18 years of age) and their non-offending caregivers who present with a history of sexual assault and/or serious physical injury receive the mental health services they need.

Fiscal Responsibility: Payment for mental health services includes Medicaid or private insurance first. If the family has no payment options, if and only if the CACGHC has funding available (To be determined by the executive board) the CACGHC will pay for 4 therapy session. In cases where the therapist assesses a need for additional sessions, the CACGHCExecutive Director may authorize payment of additional sessions.

Confidentiality:

All parents, Managing Conservators, and clients (when appropriate) will sign necessary release forms when entering therapy. The release of information forms will allow for a sharing of appropriate information between CACGHC, MDT members and therapists as is appropriate and necessary. It is not the purpose of therapy to be an extension of an abuse investigation. However, when disclosures or outcries are made, these will be shared appropriately in an effort to ensure the safety of every child.

Therapists are considered a part of the Multi-Disciplinary Team and, as such, will adhere to the confidentiality statement included elsewhere in this protocol.

Scheduling:

  1. At the time of the forensic interviews, appropriateness for counseling referrals will be discussed by theCACGHC staff, MDT members and the family of the child. Counseling resources will be discussed with the family including individual and family services available.
  1. Families will be screened for available counseling benefits through private insurance, Medicaid, CHIPS or Crime Victim’s Compensation. When appropriate, counseling referrals will be made by CACGHC staff. If no funding sources are available by the family, short-term counseling will be provided through the CACGHC as funds are available. If no resource is available through the CACGHC, then CACGHC will seek community resources for the family.
  1. If the need for Crisis Counseling is present at theCACGHC on the day of the forensic interview the CACGHC staff will assist in the reduction of trauma while making every effort to ensure the child or adult in crisis receives services that day. Crisis Counseling may be defined as a child or adult in crisis such as a suicidal or homicidal threat or highly emotional individuals who are unable to gain control or are crying inconsolably or seem to be hysterical.
  1. The family will initiate professional counseling services through a Counseling Referral from the CACGHC staff to the contracted counselor location of choice or through community resources located by CACGHC staff.
  1. Victim support and advocacy is available throughout the investigation and prosecution when needed. CACGHC contracted counselors, and the Child Advocate, may provide these services.

Counselors will provide a monthly summary to the CACGHC for the Multidisciplinary Team Meetings.

CASE CRITERIA

The Children's Advocacy Center of Gregg and Harrison Counties is committed to providing multi-disciplinary services to child victims of physical and/or sexual abuse as described in the Texas Family Code (261, 262 and all others that apply) and the Penal Code (22.04, 22.011 (a) (2), 21.11, 43.24, 43.25 and all others that apply). The CACGHC will also provide services for children who are witnesses to a felony offense and/or domestic violence witness.

The ages accepted for forensic interviewing are generally age two through age seventeen.

The ages accepted for sexual assault exams are generally infants through age seventeen.

INVESTIGATIVE PROTOCOL

  1. Law Enforcement and Child Protective Services will refer appropriate cases of alleged sexual abuse and major physical abuse for interviews and MDT follow up to the CACGHC.
  1. Investigations should be pursued collaboratively. Agencies agree to handle child abuse investigations as joint endeavors to ensure thorough investigations. Agencies agree that the utmost communication and participation is critical for the purpose of ensuring effective and successful resolution of cases. A joint investigation serves to reduce duplication of services, increases communication, and minimizes traumatization of the child.
  1. When law enforcement learns there is reason to believe a child has suffered abuse in an environment where notification of Child Protective Services is required, that notification shall be made immediately by law enforcement to the statewide hotline and to the local CPS office.
  1. When Child Protective Services learns there is reason to believe a child has suffered abuse and a possible crime has been committed requiring a law enforcement investigation, the appropriate agency will be notified immediately. CPS can make the report on behalf of the child.
  1. Due to a child’s age and or developmental level it may be necessary for law enforcement or CPS to briefly interview a child to determine the need for further action. These brief interviews should determine a child’s ability to answer “who” and “what” questions. For example, “Who lives at yourhouse?” and “What did you have for breakfast?” In cases where the child can answer “who” and “what” these brief interviews should not substitute for a planned, comprehensive forensic interview at the CACGHC.
  1. The referring agency is responsible for contacting the CACGHCand providing the completed referral form. The CACGHC staff will schedule the interview and notify the appropriate team members with the confirmation of the date and time of the forensic interview.
  1. Alleged perpetrators will not be allowed on the premises. Every effort will be made to prevent contact between the alleged victim and the alleged perpetrator. If an alleged perpetrator comes to the CACGHC, the caseworker or law enforcement agent will escort the alleged victim to a separate part of the building. The alleged perpetrator will be asked to leave immediately. If no law enforcement officer is on the scene and the alleged perpetrator refuses to leave, the police will be called immediately.

The following aresuggested stepsfor referral of a child abuse case (sexual or physical) from first report to final disposition of case: