Written by Hannah Harp
Spoon Feed
Three experts looked at non-mandated Child Protective Services (CPS) reporting through an equity lens and created guidelines about when it’s helpful to report a patient or family to CPS – and when it’s not.
Synopsis
This article examines when pediatric clinicians should report concerns to Child Protective Services (CPS) and emphasizes the importance of judicious reporting to avoid unnecessary harm to families. The authors outline the inequities in CPS investigations, particularly affecting Black and low-income families, and highlight that most reports do not lead to support or improved outcomes for children. The guidelines recommend leveraging alternative resources and consulting child abuse specialists to address suspected abuse. (AI-generated, physician edited)
Who you gonna call?
- More CPS reporting does not necessarily improve child safety, with just 16% of reports substantiated each year, but it is costly for taxpayers and families.
- CPS reports often do not connect struggling families with the help they need. Consider social services or local charitable organizations first.
- If you suspect abuse but are not sure, call a child abuse pediatrician first BEFORE calling CPS. CPS doesn’t determine abuse, but relies on us to help establish this.
- For parental substance abuse, you must develop a safe plan of care, but are not mandated to report to CPS unless there is imminent harm to the child or clear signs of neglect.
- Rule out structural and cultural barriers to adherence before reporting for medical neglect. Consider medical taxis or telehealth visits. For patients with a mistrust of the health care system, discuss ways to make treatment more comfortable for them before reporting.
How will this change my practice?
I like that these experts are recommending using other resources — a consulting child abuse pediatrician, social worker, material funds or supplies — before reporting non-urgent neglect cases to CPS. Problem-solving can avoid stressful, costly, and frequently futile investigations, and those costs fall most heavily on Black and minority families. Keep in mind what CPS can and can’t do — if it’s something we can do, we should do it. It can be a tricky line to walk. Get familiar with what a CPS report triggers in your jurisdiction — can it get a simple welfare/environmental check, or will it involve police and court dates every time?
Source
Should I Call Child Protection?-Guidelines for Clinicians. JAMA Pediatr. 2024 Nov 1;178(11):1095-1096. doi: 10.1001/jamapediatrics.2024.3624. PMID: 39283630.
