{"Multiple_Choice__291":"Kristine Frick","Short_Answer__292":"Meg Carriveau","Date__293":"10\/25\/2017","Multiple_Choice__294":"Fatality","Yes_or_No__295":"No","Multiple_Choice__300":"8","Multiple_Choice__301":"Hennepin","Short_Answer__303":"Robert","Short_Answer__304":"McClendon Jr.","Date__305":"01\/13\/2017","Date__306":"05\/17\/2017","Multiple_Choice__308":"4 Months","Multiple_Choice__309":"1","Short_Answer__310":"Father","Multiple_Choice__316":"4","Short_Answer__317":"No Documentation of interview being offered with the alleged father in the CP FA","Free_Text__318":"The father was upset about CP involvement and controlling.  The mother informed the worker that the father was aware of the worker's request to meet on 1\/18.  The worker's contact information was provided to the mother to give to the father, and the mother advised she would give the card to him, but he would decide if he wanted to contact the worker or not. The worker recalled the father to be involved, but controlling.  The mother indicated the alleged father signed recognition of parentage and the birth certificate for the subject child. Typical practice when a father is willing to engage with the worker, is for the worker to encourage him to meet so the worker can explain how to establish his rights as the father.","Short_Answer__320":"Child Protection Family Assessment case used face to face contacts from prior Child welfare case.","Free_Text__321":"Case was open as child welfare assessment on 12\/20\/2016 for prenatal exposure concerns to unborn child. CW assessment was reassigned to new worker on 01\/17\/2017 due to previous worker out on extended leave.  (Previous worker had made face to face contact with mother in December).  Worker uses an engagement approach during the child welfare assessment prior to baby's birth to build rapport and offer services for the mother. Also gather's names of relatives for future reference if needed. Worker did not identify risk to any sibling children and did not note significant history for the mother or father. \r\n\r\nChild was born on 01\/13\/2017. Face to face observation of the subject child and interview with the mother occurred. PSOP services were discussed on 1\/18.  \r\nMultiple attempts to reach hospital social worker occurred on 1\/18, 1\/26, and 1\/30. On 1\/30, reached the hospital social worker, and learned the mother tested positive for THC, no other illicit drugs. Worker make new CP report when learned mother tested positive for THC. \r\n1\/30\/2017 \u00e2\u20ac\u201c Family Assessment opened and case notes for face to face contacts were documented from previous work with the mother and observation of the child on 1\/18 face to face during the child welfare assessment. Meconium for subject child was not screened. Hospital did not make new report to Child Protection about the birth of the baby and the mother testing positive for THC at time of child's birth. The CW Assessment completed and closed on 2\/21\/2017. \r\n\r\nIt is common practice for an open child welfare assessment for prenatal exposure to close and open as a family assessment at time of child's birth (depending on results of mother and newborns tox screens). For this case the mother tested positive for THC and child's meconium was not tested, so opening family assessment is common procedure, noting that the hospital hadn't reported either. The mother was cooperative, and was aware of the expectations from the child welfare assessment. It made sense to the worker to use the previous contacts given the flow of the already opened CW Assessment and opening of the FA assessment.","Short_Answer__323":"Documentation of numerous attempts made, and a significant amount of time spent, accessing medical record from the local hospital.","Free_Text__324":"The decision to determine maltreatment, (or not), was dependent on context included within a specific medical record regarding a doctor appointment day prior to child's death.   \r\n\r\nIt was learned that it took multiple contacts and a lot of persistence to receive the medical record needed. Investigations writes request via County Letterhead, including the statute which allows them access to medical records during an open CP investigation. The amount of time spent trying to access the records is somewhat how operations typically go between the hospital and child protection investigations, but this particular case it created significant concern due to the amount of time spent waiting on getting the information needed. The ME report typically takes 2-3 months to receive for child death cases and this occurred for this investigation.\r\n\r\nThe medical records department follows a strict procedure of releasing only exact date and clinic location where care received for an individual.  The information requested is included on County Letterhead, with the Statute allowing investigations access to the child's records. A release of information is not needed, but if specific date or location is not known where child received medical care, the information will not be included just by providing a child's name. It is not possible to request all records without including dates, so if there was a discrepancy in exact date, or an exact location where care was received, this becomes problematic. Ultimately, the decision to find maltreatment was delayed due to amount of time it took to obtain access to the specific medical record that was needed to inform preponderance of evidence to use in determining maltreatment.\r\nTimeline: \r\n9\/6\/2017 -Consult occurred with upper management about next steps for the investigation and if preponderance of evidence met or not met. Need medical records to understand context of parents' awareness and education of risk to their infant.\r\n9\/7\/2017- Requested medical records\r\n9\/12\/2017 -Follow up call to medical records department. Request for records is being processed. Medical records department cannot fax medical records due to protected health information. They can mail them when ready. \r\n9\/12\/2017 \u00e2\u20ac\u201c Collateral hospital social worker contact informs about a different clinic and resident provider who saw the subject child. Social worker could not release the record, but shared verbally the context of what education and directives were given to the caregivers by the doctor.  \r\n10\/2\/2017 -Follow up call to medical records department. Medical records included 600+ pages of medical records information and were mailed on 9\/21\/2017. \r\n10\/6\/2017 \u00e2\u20ac\u201c Receipt of 600+ pages of medical records information; Consultation with supervisor regarding medical documentation not including needed medical note from doctor appointment. New request sent back to medical records department at local hospital. \r\n10\/13\/2017 \u00e2\u20ac\u201c Worker walk to local hospital and hand delivered a written request for medical note for subject child's doctor appointment that took place at the specific location on the specific date. The records personnel reported they do not provide documentation in hand, but was able to print off the medical notes and provided to the worker. Department was waiting on the medical notes from doctor appointment to determine whether to make maltreatment finding or not. It was dependent on what was included in the context of the medical appointment note.","Free_Text__325":"Debrief only\/ No Map\/ Mapping team decision to score this area of learning using the systems analysis tool.","Short_Answer__326":"Case referred to PSOP case management rather than family assessment case management","Free_Text__327":"Consult with CP Supervisor determined to close the family assessment and make a referral to PSOP. Cases that involve just THC, most likely won't open to field, and they may or may not open to PSOP.  \r\nThere was an internal protocol to follow about making the PSOP referral at that time which the worker completed. PSOP was a contracted service through a community agency.","Free_Text__328":"Debrief only\/ No Map\/ Mapping team decide to score this area of learning using the systems analysis tool.","Multiple_Choice__368":"2","Free_Text__369":"LP3: Documentation of numerous attempts and a significant amount of time being spent to access medical records from the local hospital, which delayed a decision about maltreatment. \r\nIt took CP worker multiple contacts and a lot of persistence to receive the medical record needed.  Investigations writes request via County Letterhead, included in the context of the Letter is the statute which allows them access to medical records during an open CP investigation. The amount of time that was spent trying to access the records was somewhat typical, but it does not support the work CP is trying to achieve, especially for this particular case, the time spent trying to obtain the medical records created a barrier, and caused delay in CP investigator being able to make a maltreatment determination. A significant amount of time was spent waiting on getting the information needed. The hospital's medical records department follows a strict procedure of releasing only exact date and clinic location where care received for an individual. The information requested is included on County Letterhead, with the Statute allowing investigations access to the child's records. A release of information is not needed, But if specific date or location is not known where child received medical care, the information will not be included just by providing a child's name. It is not possible to request all records without including dates, so if there was a discrepancy in exact date, or an exact location where care was received, this becomes problematic. Ultimately, the decision to find maltreatment was delayed due to amount of time it took to obtain access to the specific medical records needed to inform preponderance of evidence.","Multiple_Choice__358":"2","Free_Text__359":"Unsafe sleep critical incident. Maltreatment determined for Neglect - Inadequate supervision to subject child by the alleged father.","Yes_or_No__370":"Yes"}