Key Observation: Child protection report met screen in criteria for Medical Neglect according to the Intake, Screening, and Response Path Guidelines, however, the child protection report was screened out.
As a result of juvenile diabetes being generally hard to manage and to ensure consistency with screening these cases, the local agency established additional requirements around medical neglect reports for juvenile diabetes. These requirements look for a physician's statement indicating adverse effects on the child as a result of the caregivers neglect for their child's medical needs or that hospitalization was necessary as a result of the medical neglect. The decision to screen the report out was influenced by the report not containing either a medical provider's statement that indicated any adverse effects on the child or that hospitalization was needed. Further supporting the agency's decision to screen the report out was that a medical provider, specifically the medical provider involved with the subject child's diabetic care, was not reporting any concerns to the local agency or to the school.
Additional considerations that supported the agency's decision to screen the report out was that the family did not have previous involvement with the child protection system as well as the child's disability status. It was not clear to the agency that the behavioral concerns noted within the child protection report were resulting from the juvenile diabetes or from the child's disability. As a result of this, the information contained in the report which indicated that the behavioral concerns noted were directly correlated to the medical neglect of the child's juvenile diabetes needs was dampened.
Further influencing the agency's decision to screen this case out was that the local agency also placed less significance on the information contained in the report due to the time it took the school to report the information. The report being made at the end of the school year was prompted by the need to ensure that the child's diabetes was being managed outside of the school since the school had assumed this responsibility throughout the school year. Furthermore the delay in reporting coupled with the report coming at the end of the school year also influenced the agency's decision to screen the report out as the local agency consistently experienced an increase of child maltreatment reports at the end of each school year that routinely did not meet the threshold to be screened in for a child protection response.
Previous experiences with responding to juvenile diabetes reports also influenced staff's decision to screen this case out. Staff indicated that they had previously screened in a very similar case that resulted in a child protection investigation and an unnecessary removal of a child from his caregivers. This experience was very traumatic for the child, the family, and the staff involved in this case. As a result of this, all staff involved in the screening decision including staff involved with the previous case noted extra caution when screening and responding to this case as to not repeat actions and cause any unnecessary harm to the child and his family through a child protection response. Staff also noted that as a team this previous case and its particular impact on staff involved in this screening decision was openly discussed to try and mitigate any biases based upon the previous case when making the decision to screen this case in or out.